Related Experiment Video
Updated: Feb 13, 2026

Drosophila Adult Olfactory Shock Learning
Published on: August 7, 2014
Hydrocortisone plus Fludrocortisone for Adults with Septic Shock
Djillali Annane1, Alain Renault1, Christian Brun-Buisson1
1From Service de Médecine Intensive et Réanimation, Hôpital Raymond Poincaré, Garches (D.A., V.M.), Laboratory of Infection and Inflammation Unité 1173, University of Versailles Saint-Quentin-en-Yvelines, INSERM, Montigny-le-Bretonneux (D.A.), Service de Pharmacologie Clinique-Centre d'Investigation Clinique (CIC) INSERM 1414, Centre Hospitalier Universitaire (CHU) de Rennes-Université de Rennes 1, Hôpital Pontchaillou, Rennes (A.R., E.B.), Service de Réanimation Médicale (C.B.-B.) and Service d'Anesthésie et des Réanimations Chirurgicales (G.D., F.C.), Hôpital Henri-Mondor (Assistance Publique-Hôpitaux de Paris [AP-HP]), Créteil, Réanimation Médicale et Toxicologique, Hôpital Lariboisière (AP-HP), Université Paris-Diderot, INSERM Unité Mixte de Recherche Scientifique (UMRS) 1144 (B. Megarbane), Réanimation Médicale-Hôpitaux Universitaires Paris Centre-Site Cochin (AP-HP) and Université Paris Descartes (A. Cariou), Médecine Intensive et Réanimation, Pôle 2i, Infection et Immunité, Hôpital Bichat-Claude Bernard, AP-HP, Infection, Antimicrobiens, Modélisation, Evolution (IAME) Unité 1137, Université Paris Diderot, INSERM (J.-F.T.), Service d'Anesthésie et Réanimations Chirurgicales, Hôpitaux Universitaires Paris Centre-Site Cochin (AP-HP) (F.B.), and Service de Réanimation Médicale, Hôpital Pitié-Salpêtrière (AP-HP), and Université Paris Sorbonne INSERM, UMRS 1166-Institute of Cardiometabolism and Nutrition (A. Combes), Paris, Service de Réanimation Médicale, Hôpital Universitaire François Mitterrand, Lipness Team, INSERM Research Center Lipids, Nutrition, Cancer-Unité Mixte de Recherche (UMR) 1231 and Laboratoire d'Excellence LipSTIC, and CIC 1432, Epidémiologie Clinique, Université de Burgundy, Dijon (J.-P.Q., A.D.), Service d'Anesthésie-Réanimation, Centre Hospitalier d'Etampes, Etampes (S.S., T.H.), Réanimation Médico-Chirurgicale, CIC INSERM 1414, Grand Hôpital de l'Est Francilien Site de Meaux, Hôpital Saint Faron, Meaux (X.F.), Service de Réanimation Médicale, CHU de Grenoble, Grenoble (C.S.), Service d'Anesthésie et de Réanimation, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Aix Marseille Université, CIC 1409, and CIC 9502, Marseille (C.M.), Service de Réanimation Polyvalente, Groupe Hospitalier Paris Saint Joseph, and Service de Réanimation Médicale, CHU de Rouen-Hôpital Charles Nicolle, Rouen (B. Misset), Service de Réanimation Polyvalente, Centre Hospitalier de Valenciennes, Valenciennes (M.A.B.), Service de Réanimation Médico-Chirurgicale, Centre Hospitalier Départemental de Vendée, Site de La Roche-sur-Yon, Les Oudairies, La Roche-sur-Yon (G. Colin), Réanimation Médicale Polyvalente, CHU Gabriel Montpied (B.S.), and Pôle de Médecine Péri-Opératoire, Génétique, Reproduction, et Développement, UMR-Centre National de la Recherche Scientifique 6293, Université Clermont-Auvergne, INSERM Unité 1103, CHU Clermont-Ferrand (J.-M.C.), Clermont-Ferrand, Service d'Anesthésie, Réanimation Chirurgicale, Hôtel Dieu-Hôpital Mère-Enfant, CHU Nantes, Laboratoire EA3826 Thérapeutiques et Expérimentales des Infections, Nantes (K.A.), Réanimation Polyvalente, Centre Hospitalier Régional Universitaire Bretonneau, Tours (E.M.), Service d'Anesthésie-Réanimation, Centre Hospitalier de Périgueux, Périgueux (L.C.), Service de Réanimation Chirurgicale, Hôpital Central, CHU de Nancy, Nancy (C.C.), Service de Réanimation Polyvalente, INSERM CIC 1435-CHU Dupuytren, Limoges (B.F.), Service Réanimation Médicale Polyvalente et Unité de Surveillance Continue, Centre Hospitalier Régional d'Orléans, Orléans (T.B.), Réanimation Chirurgicale, Département d'Anesthésie-Réanimations-Urgences, Service d'Assistance Médicale d'Urgence (SAMU) 86, Hôpital de la Miletrie, CHU, Poitiers (F.P.), Service de Réanimation Médicale, Centre Hospitalier Lyon-Sud (Hospices Civils de Lyon), Pierre-Bénite (J.B.), Service d'Anesthésie-Réanimation, Hôpital Saint Camille, Bry-sur-Marne (J.-F.L.), Réanimation Polyvalente, Hôpital Jean Verdier (AP-HP), Bondy (R.A.), Service de Réanimation Médicale, CHU Amiens-Picardie-Site Sud, Amiens (M.S.), Service de Réanimation Médicale et Maladies Infectieuses, Centre Hospitalier Tourcoing Gustave Dron, Tourcoing (O.L.), and Service de Réanimation Médicale-SAMU 25, Hôpital Jean Minjoz-CHU de Besançon, Besançon (G. Capellier) - all in France.
Hydrocortisone plus fludrocortisone significantly reduced 90-day mortality in septic shock patients. This combination therapy improved survival and reduced organ failure, offering a new treatment option for this critical condition.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pharmacology
Background:
- Septic shock involves complex host response dysregulation, including circulatory, cellular, and metabolic abnormalities.
- Previous research explored therapies like hydrocortisone plus fludrocortisone and drotrecogin alfa (activated) to modulate the host response in septic shock.
Purpose of the Study:
- To evaluate the clinical outcomes of septic shock patients treated with hydrocortisone plus fludrocortisone, drotrecogin alfa (activated), or their combination.
- To determine the effect of these therapies on 90-day all-cause mortality and other secondary outcomes.
Main Methods:
- A multicenter, double-blind, randomized trial with a 2-by-2 factorial design was initially conducted.
- The trial design was adapted to a two-group parallel design after drotrecogin alfa (activated) was withdrawn.
- The primary endpoint was 90-day all-cause mortality, with secondary endpoints including ICU and hospital discharge mortality, and days free of vasopressors, mechanical ventilation, or organ failure.
Main Results:
- 90-day all-cause mortality was significantly lower in the hydrocortisone-plus-fludrocortisone group (43.0%) compared to the placebo group (49.1%) (P=0.03).
- The hydrocortisone-plus-fludrocortisone group showed significantly more vasopressor-free days (17 vs. 15, P<0.001) and organ-failure-free days (14 vs. 12, P=0.003).
- Hyperglycemia was more frequent in the hydrocortisone-plus-fludrocortisone group, but serious adverse events did not differ significantly.
Conclusions:
- Hydrocortisone plus fludrocortisone therapy significantly reduced 90-day all-cause mortality in patients with septic shock.
- The study supports the use of hydrocortisone plus fludrocortisone for improving survival and clinical outcomes in septic shock.
Related Concept Videos
Shock Waves
When the source's speed approaches the speed of sound, constructive interference between successive wavefronts emitted by the source occurs immediately behind it. Initially, scientists believed that this constructive interference would result in such high...
Blood Pressure Imbalances and Circulatory Shock
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Adult Stem Cells
Cardiopulmonary Resuscitation I: Adult
Relationship with Other Adult Family Members and Siblings
Revisionist Views of Adolescent and Adult Cognition

