Trial reportLiver international : official journal of the International Association for the Study of the Liver2025
Low-Dose Hydrocortisone in Cirrhotic Patients With Septic Shock: A Double-Blind Randomised Placebo-Controlled Trial.
Trial report in Liver international : official journal of the International Association for the Study of the Liver, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02602210 (Supplemental Corticosteroids in Cirrhotic Hypotensive Patients With Suspicion of Sepsis), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Supplemental Corticosteroids in Cirrhotic Hypotensive Patients With Suspicion of Sepsis
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Corticosteroids for sepsis and septic shock: a meta-analysis of 18 RCTs with dose-stratified and fludrocortisone subgroup evaluation.BMC anesthesiology · 2025Pooled it
- Low-Dose Hydrocortisone in Cirrhotic Patients With Septic Shock: A Double-Blind Randomised Placebo-Controlled Trial.Liver international : official journal of the International Association for the Study of the Liver · 2025Trial
- Beyond the Tipping Point: Advances in the Diagnosis and Management of Acute-on-Chronic Liver Failure and End-Stage Liver Disease.Diagnostics (Basel, Switzerland) · 2026Review
- Sensitivity of diagnosis of spontaneous bacterial peritonitis is higher with the automated cell count method.World journal of hepatology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
Abstract
BACKGROUND AND
aimsSteroid supplementation remains controversial in septic shock, partly due to the heterogeneity of the populations studied. Cirrhotic patients with sepsis frequently develop relative adrenal insufficiency, showing poor response to vasopressors and poor prognosis. Early administration of low-dose hydrocortisone might facilitate shock reversal and reduce mortality in this population.
methodsDouble-blind, randomised, placebo-controlled multicentre trial, enrolling adult cirrhotic patients with septic shock. Patients were assigned to receive i.v. hydrocortisone (100 mg followed by a continuous infusion of 200 mg/24 h) or placebo, for at least 3 days, followed by a tapering period of 3-7 days, depending on the time of shock resolution. Primary endpoint was 28-day all-cause mortality.
resultsAfter enrolment of 83 patients the trial was stopped early due to slow inclusions. Most patients required low-to-moderate doses of vasopressors. There was no difference in 28-day mortality (35% vs. 39.5%; p = 0.84) between hydrocortisone and placebo groups. Shock resolution (85% vs. 72.1%; p = 0.25) and days to shock resolution [3 days (2.2-4; IQR) vs. 4 (2-7.5; IQR)] were also similar between groups. More patients receiving placebo died of refractory shock (47.6% vs. 8.7%). No significant differences between treatment arms were observed in shock relapse, new shock episodes or bacterial or fungal superinfections during hospital stay. Hypo- and hyperglycaemias were more frequent in the hydrocortisone arm. Severity of ACLF at inclusion and inadequacy of empirical antibiotic therapy (HR = 6.40; 95% CI: 3.21-12.79) independently predicted 28-day mortality.
conclusionsSupplemental hydrocortisone did not improve short-term survival in cirrhotic patients with septic shock requiring low-to-moderate doses of vasopressors.
trial registrationS-number University Hospitals Leuven, Belgium: S55168; EUDRACT: 2010-024273-38; Clinicaltrials.gov id: NCT02602210.
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