Trial reportThe Clinical investigator1994
Low-dose hydrocortisone infusion attenuates the systemic inflammatory response syndrome. The Phospholipase A2 Study Group.
Trial report in The Clinical investigator, 1994. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00732277 (Evaluation of Corticosteroid Therapy in Childhood Severe Sepsis), which is not on this map. Cited by 30 papers, 3 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.
Evaluation of Corticosteroid Therapy in Childhood Severe Sepsis (Steroids in Paediatric Sepsis, StePS) - a Randomised Pilot Study
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 155 citations in OpenAlex.
- Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2025Pooled it
- Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2019Pooled it
- Corticosteroids for treating sepsis.The Cochrane database of systematic reviews · 2015Pooled it
- Effects of single dose of dexamethasone on patients with systemic inflammatory response.Sao Paulo medical journal = Revista paulista de medicina · 2006Trial
- [The necessity for perioperative cortisol substitution. Spontaneous and stimulated ACTH and cortisol secretion during unilateral adrenalectomy for renal cell carcinoma].Der Anaesthesist · 1997Trial
- Towards Drug Repurposing in Cancer Cachexia: Potential Targets and Candidates.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Immune Effects of Corticosteroids in Sepsis.Frontiers in immunology · 2018Review
- TCM-Mesh: The database and analytical system for network pharmacology analysis for TCM preparations.Scientific reports · 2017Article
- Protective effect of phosphatidylcholine on lipopolysaccharide-induced acute inflammation in multiple organ injury.The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology · 2013Article
- Glucocorticosteroid in treatment of severe pneumonia.Mediators of inflammation · 2013Review
- The glucocorticoid-induced leucine zipper (gilz/Tsc22d3-2) gene locus plays a crucial role in male fertility.Molecular endocrinology (Baltimore, Md.) · 2012Article
- Effects of low-dose hydrocortisone therapy on immune function in neonatal horses.Pediatric research · 2011Article
- A physiological model for autonomic heart rate regulation in human endotoxemia.Shock (Augusta, Ga.) · 2011Article
- Low-dose dexamethasone prevents endotoxaemia-induced muscle protein loss and impairment of carbohydrate oxidation in rat skeletal muscle.The Journal of physiology · 2010Article
- Relative adrenal insufficiency in the preterm and term infant.Journal of perinatology : official journal of the California Perinatal Association · 2009Review
- [Corticosteroid insufficiency in the critically ill. Pathomechanisms and recommendations for diagnosis and treatment].Der Anaesthesist · 2009Review
- Adjunctive therapies in severe sepsis and septic shock: current place of steroids.Current infectious disease reports · 2008Article
- The hypothalamic-pituitary-adrenal axis in critical illness.Reviews in endocrine & metabolic disorders · 2007Review
- What is the rationale for hydrocortisone treatment in children with infection-related adrenal insufficiency and septic shock?Archives of disease in childhood · 2007Review
- Effect of glucocorticoid pretreatment on oxidative liver injury and survival in jaundiced rats with endotoxin cholangitis.World journal of surgery · 2006Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There is increasing evidence that the hypercortisolemia in inflammatory diseases suppresses the elaboration of proinflammatory cytokines, thus protecting the host from its own defence reactions. In severe sepsis and septic shock cortisol levels are usually elevated, but some patients may have relative adrenal insufficiency. This may contribute to the overwhelming systemic inflammatory response syndrome. We evaluated the impact of low-dose hydrocortisone infusion (10 mg/h) on the course of the systemic inflammatory response syndrome. This dose corresponds to a maximum secretory rate of cortisol achieved in corticotropin-stimulated healthy humans. In a prospective observational study 57 surgical patients with severe sepsis or septic shock were studied, of which in addition to the conventional treatment 12 patients were infused with low-dose hydrocortisone, and 45 were treated without any corticosteroid. In the longitudinal analysis the systemic inflammatory response--as judged by body temperature, cardiovascular response, and kinetics of inflammatory mediators such as phospholipase A2, C-reactive protein, and neutrophil elastase--started to differ in favor of the hydrocortisone-treated patients after 2 days of treatment (P < 0.05, Mann-Whitney U test). The difference disappeared after withdrawal of exogenous cortisol. Shock reversal was achieved in all patients treated with low-dose hydrocortisone. The data provide evidence that low-dose hydrocortisone infusion attenuates the systemic inflammatory response in human septic shock. From an immunological point of view a relative cortisol deficiency may contribute to the amplified immune response in systemic inflammatory diseases. A randomized clinical trial must clarify the impact of low-dose hydrocortisone infusion on the clinical course and outcome of septic shock patients.
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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.