Hyperglycemia Risk Evaluation of Hydrocortisone Intermittent Boluses versus Continuous Infusion in Septic Shock: A...

Area of Science:

• Critical Care Medicine
• Endocrinology
• Pharmacology

Background:

• Hydrocortisone is crucial for managing septic shock, but hyperglycemia is a common side effect.
• Corticosteroid treatment, including hydrocortisone, is associated with hyperglycemia.

Purpose of the Study:

• To compare the risk of hyperglycemia between intermittent hydrocortisone boluses and continuous infusion in patients with septic shock.
• Evaluate the impact of different hydrocortisone administration methods on blood glucose levels.

Main Methods:

• A prospective randomized controlled study involving 140 patients with septic shock receiving noradrenaline.
• Patients were divided into two groups: intermittent hydrocortisone bolus (n=70) and continuous hydrocortisone infusion (n=70).
• The primary outcome measured was mean blood glucose levels; secondary outcomes included hyperglycemic/hypoglycemic events, mortality, and ICU length of stay.

Main Results:

• No statistically significant or clinically relevant difference in mean blood glucose levels between the intermittent bolus (154.44 mg/dL) and continuous infusion (160.2 mg/dL) groups.
• Similar rates of hyperglycemic or hypoglycemic events, mortality, and intensive care unit length of stay were observed in both groups.
• The study excluded patients receiving over 200 mg of hydrocortisone daily.

Conclusions:

• The risk of hyperglycemia is comparable between intermittent bolus and continuous infusion hydrocortisone administration in septic shock patients.
• Neither method demonstrated superiority in terms of glycemic control or clinical outcomes.