Effects of low -dose hydrocortisone succinate at early stage of septic shock

ZHENG Liang-liang; YUAN Ying; LI Chen; ZHU Hua-dong; XU Jun; YU Xue-zhong

doi:10.3969/j.issn.1002-1949.2015.12.008

Abstract：Objective To observe the effects of hydrocortisone succinate in addition to conventional therapy at early stage of septic shock. Methods Thirty-seven patients of septic shock were sequentially divided into conventional treatment group( control group) and hydrocotisone in addition to conventional treatment group(research group).Serum interleukin-6(IL-6),mean arterial pressure (MAP), norepinephrine dosage and lactate clearance of the two groups on day0(before treatment),day1 and day2 were determined and compared.The mortalities were compared in 14 days between the two groups.Results There was no significant difference in the above parameters between the two groups at baseline(d0).The serum levels of IL-6 of both groups were significantly decreased on d1[(58.93 ± 108.39)pg/mL vs.(91.65 ±94.46)pg/mL] and d2[(30.52 ±48.81)pg/mL vs.(49.50 ±54.69) pg/mL], and the treatment group decreased more apparently(P<0.05)].Comparing to the control group, the dosage of norepinephrine was decreased more significantly, the MAP [d1:(74.84 ±5.11) mm Hg vs.(68.78 ±4.49)mm Hg, d2:(80.53 ±2.97)mm Hg vs.(76.89 ±4.32)mm Hg)]and the lactate clearance[d1:(37.04 ±2.63)%vs.(19.21 ±3.21)%, d2:(54.89 ±6.72)% vs.(41.67 ± <br> 7.43%)]were significantly higher in research group.But the 14 -day mortality was not statistically significant different between research group and control group(42.1% vs.44.4%, P >0.05). Conclusion Hydrocortisone succinate early added in routine treatment of septic shock could reduce inflammatory response by inhibiting the expression of IL-6, and reduce the dosage of norepinephrine and improve MAP and lactate clearance.It could improve tissue perfusion faster and play a positive role in adjuvant therapy in patients with septic shock.