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ADRENAL (view source)

Revision as of 00:35, 30 January 2018

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==Major Points==
==Major Points==
<!-- This section should be able to stand on its own as a summary of the trial, i.e., if someone read just that section, they should be able to know why the trial was done, what was found, and the implications of the findings. This can be done by writing three paragraphs: 1. Background leading to the study, 2. an overview of the findings of the study, and 3. implications of the study/follow-up studies (if there are such studies).
Multiple RCTs have investigated the potential role for steroid therapy in patients with septic shock. The [[Annane Trial]] in 2002 with 299 patients demonstrated a short-term mortality benefit with IV hydrocortisone and fludrocortisone among patients with evidence of adrenal insufficiency on ACTH stimulation testing. [[CORTICUS]] with 499 patients in 2008 investigated hydrocortisone in patients with and without adrenal insufficiency and found a faster reversal of shock but no benefit in either subgroup with suggestion of increased infection rates in patients receiving hydrocortisone. [[HYPRESS]] in 2016 with 380 patients showed no difference in mortality but showed decrease time to reversal of shock.
 
A few paragraphs summarizing the clinical question, the study itself, and how to apply it to practice. A simple approach is to use the first paragraph to discuss the background, use the second paragraph to discuss the study design and outcomes, and the third paragraph for interpretation which should incorporate criticisms, meta-analyses, and review-type content.-->


==Guidelines==
==Guidelines==
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