Trial reportCritical care (London, England)2016
Corticosteroid therapy in refractory shock following cardiac arrest: a randomized, double-blind, placebo-controlled, trial.
Trial report in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 28 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Corticosteroids Therapy in Refractory Shock Following Cardiac Arrest
Arterial Pressure and Stress-Dose Steroids in In-hospital Cardiac Arrest: a Mediation Analysis of Prior Randomized Clinical Trial Data.
Comparison of the Effect of Vasopressin, Steroid, and Epinephrine Treatment in Patients With Out-of-hospital Cardiac Arrest: Multi-center, Double Blind, Randomized, Placebo-controlled Study
Corticosteroids to Reduce Inflammation in Severe Pancreatitis: A Randomized, Controlled Study
Who cites it
28 citing papers in PubMed, 5 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 6. Post-cardiac arrest care.Clinical and experimental emergency medicine · 2026Guideline
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- Efficacy and safety of corticosteroids in cardiac arrest: a systematic review, meta-analysis and trial sequential analysis of randomized control trials.Critical care (London, England) · 2023Pooled it
- Efficacy and safety of corticosteroid therapy in patients with cardiac arrest: a systematic review of randomised controlled trials.European journal of clinical pharmacology · 2020Pooled it
- Immunomodulatory interventions in myocardial infarction and heart failure: a systematic review of clinical trials and meta-analysis of IL-1 inhibition.Cardiovascular research · 2018Pooled it
- Steroid, thiamine, and ascorbic acid for comatose out-of-hospital cardiac arrest survivors (STAR): a randomised, placebo-controlled, phase 2 trial.EClinicalMedicine · 2026Article
- Hyperacute Cytokine Kinetics and Early Interleukin-10 Elevation as Predictors of Neurological Outcome in Post-Cardiac Arrest Syndrome.Journal of clinical medicine · 2026Article
- Hydrocortisone and arginine vasopressin in post-resuscitation shock: the HYVAPRESS trial.Resuscitation plus · 2025Article
- Metabolic effects of high-dose glucocorticoid following out-of-hospital cardiac arrest.Intensive care medicine experimental · 2025Article
- Article
- Inflammation, endothelial injury, and the acute respiratory distress syndrome after out-of-hospital cardiac arrest.Resuscitation plus · 2024Article
- Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society.Neurocritical care · 2024Article
- Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement From the American Heart Association and Neurocritical Care Society.Circulation · 2024Review
- Adjunctive Therapeutics in the Management of Cardiopulmonary Resuscitation: A Narrative Literature Review.Journal of clinical medicine · 2023Review
- Single-cell transcriptomics reveal a hyperacute cytokine and immune checkpoint axis after cardiac arrest in patients with poor neurological outcome.Med (New York, N.Y.) · 2023Article
- Factors associated with circulatory death after out-of-hospital cardiac arrest: a population-based cluster analysis.Annals of intensive care · 2023Article
- Physiologic effects of stress dose corticosteroids in in-hospital cardiac arrest (CORTICA): A randomized clinical trial.Resuscitation plus · 2022Article
- Clinical benefits of corticosteroid administration during adult cardiopulmonary resuscitation: A systemic review and meta-analysis.World journal of critical care medicine · 2021Article
- Vasopressor-Sparing Strategies in Patients with Shock: A Scoping-Review and an Evidence-Based Strategy Proposition.Journal of clinical medicine · 2021Article
- Post-Cardiac Arrest Hydrocortisone Use Ameliorates Cardiac Mitochondrial Injury in a Male Rat Model of Ventricular Fibrillation Cardiac Arrest.Journal of the American Heart Association · 2021Article
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundThe purpose of this study was to determine whether the provision of corticosteroids improves time to shock reversal and outcomes in patients with post-cardiac arrest shock.
methodsWe conducted a randomized, double-blind trial of post-cardiac arrest patients in shock, defined as vasopressor support for a minimum of 1 hour. Patients were randomized to intravenous hydrocortisone 100 mg or placebo every 8 hours for 7 days or until shock reversal. The primary endpoint was time to shock reversal.
resultsFifty patients were included with 25 in each group. There was no difference in time to shock reversal between groups (hazard ratio: 0.83 [95% CI: 0.40-1.75], p = 0.63). We found no difference in secondary outcomes including shock reversal (52% vs. 60%, p = 0.57), good neurological outcome (24% vs. 32%, p = 0.53) or survival to discharge (28% vs. 36%, p = 0.54) between the hydrocortisone and placebo groups. Of the patients with a baseline cortisol < 15 ug/dL, 100% (6/6) in the hydrocortisone group achieved shock reversal compared to 33% (1/3) in the placebo group (p = 0.08). All patients in the placebo group died (100%; 3/3) whereas 50% (3/6) died in the hydrocortisone group (p = 0.43).
conclusionsIn a population of cardiac arrest patients with vasopressor-dependent shock, treatment with hydrocortisone did not improve time to shock reversal, rate of shock reversal, or clinical outcomes when compared to placebo. CLINICAL
trial registrationClinicaltrials.gov: NCT00676585, registration date: May 9, 2008.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.