SynthesisMedical principles and practice : international journal of the Kuwait University, Health Science Centre2026
Continuous versus Intermittent Hydrocortisone for the Treatment of Septic Shock: A Systematic Review and Meta-Analysis.
Synthesis in Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
<p>Objectives: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and comparative cohort studies comparing continuous with intermittent intravenous hydrocortisone in adults with septic shock. SUBJECTS AND
methodsSearches of MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and <ext-link ext-link-type="uri" xlink:href="http://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link> were conducted till July 2025. The primary outcome was all-cause mortality; secondary outcomes included hospital and intensive care unit (ICU) length of stay, shock reversal, hypernatremia, hypokalemia, and vasopressor use. Risk of bias was assessed using Cochrane RoB 2.0 for RCTs and the Newcastle-Ottawa Scale for cohort studies. A random-effects model was applied, and certainty of evidence was graded using GRADE.
resultsEight studies (five RCTs, three cohort studies) including 609 patients were analyzed. Continuous infusion was not associated with a significant reduction in mortality compared with intermittent infusion (risk ratio [RR]: 0.83, 95% confidence interval [CI]: 0.65 to 1.06; p = 0.13; I2 = 36%). No significant differences were observed in hospital stay (mean difference [MD]: 0.10 days, 95% CI: -1.40 to 1.61), ICU stay (MD: -0.02 days, 95% CI: -0.63 to 0.58), shock reversal (RR: 0.94, 95% CI: 0.61 to 1.46), hypernatremia (RR: 1.05, 95% CI: 0.51 to 2.16), hypokalemia (RR: 0.64, 95% CI: 0.40 to 1.03), or vasopressor duration (MD: -0.97 days, 95% CI: -4.00 to 2.05). Certainty of evidence ranged from very low to moderate.
conclusionContinuous and intermittent hydrocortisone infusion demonstrated comparable clinical outcomes in septic shock. Large, multicenter RCTs are warranted to determine the optimal administration strategy. </p>.
Indexed as
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.