Comparative efficacy and prognostic impact of continuous versus intermittent hydrocortisone administration in septic shock patients

This study investigates the effects of continuous versus intermittent hydrocortisone administration on septic shock patients. Sixty patients were randomized into two groups: one receiving intermittent doses of 50 mg of hydrocortisone every 6 h and the other a continuous infusion of 200 mg/day. After a 7-day treatment period and a 28-day follow-up, we observed no significant differences in the duration of sustained shock, hospital, and ICU stays between the groups. However, those in the continuous infusion group experienced shorter periods of mechanical ventilation and vasopressor use, with significant improvements in hemodynamic stability. Both treatment approaches improved arterial pressure and lactate clearance, with no significant differences in heart rate or cortisol levels between the groups at the end of the treatment. Notably, shock reversal rates were higher and 28-day mortality rates were lower in the continuous infusion group. These results suggest that continuous hydrocortisone infusion may be more effective for managing septic shock, potentially leading to better patient outcomes without an increase in adverse reactions. This method could be considered for broader clinical implementation in septic shock treatment strategies.