Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
, 34 (2), 344-9

Stress Doses of Hydrocortisone in Septic Shock: Beneficial Effects on Opsonization-Dependent Neutrophil Functions

Randomized Controlled Trial

Stress Doses of Hydrocortisone in Septic Shock: Beneficial Effects on Opsonization-Dependent Neutrophil Functions

Ines Kaufmann et al. Intensive Care Med.


Objective: To assess the effects of stress doses of hydrocortisone (HC) on clinical parameters and neutrophil functions in patients with septic shock.

Design: Prospective, double-blind, randomized, placebo-controlled study.

Setting: Intensive care units of a university hospital.

Patients and participants: 30 adult patients with septic shock.

Interventions: Patients were allocated to receive either HC (intravenous bolus of 100 mg preceding a continuous infusion 10 mg/h, n = 15) or placebo (n = 15), respectively. The effects of HC were assessed at baseline and after 24 h.

Measurements and results: As compared with placebo-treated patients, administration of HC significantly decreased norepinephrine requirements (from 1.5 to 0.8 mg/h; p < 0.001), interleukin-6 serum concentrations (from 388.8 to 88.8 pg/ml; p < 0.02), and the spontaneous release of hydrogen peroxide (H2O2) by neutrophils (-33.0%; p < 0.05). Additionally, HC treatment preserved the autologous plasma-induced amplification of phagocytosis of zymosan particles [factor of opsonin-induced amplification of phagocytosis of unopsonized particles: 1.80 for placebo vs. 1.75 for HC at baseline (not significant between groups) and 0.50 for placebo vs. 1.75 for HC after 24 h of treatment (p < 0.05)]. These effects were paralleled by respective changes in the phagocytosis-associated H2O2 production.

Conclusions: In patients with septic shock stress doses of HC exert beneficial effects in terms of improvements in hemodynamics, decrease in pro-inflammatory mediators, and oxidative stress without the compromise of opsonization-dependent phagocytic neutrophil functions; thus, HC treatment does not aggravate non-specific immunosuppression but instead improves innate immunity in the early stage of septic shock.

Similar articles

See all similar articles

Cited by 21 PubMed Central articles

  • Corticosteroids for Treating Sepsis in Children and Adults
    D Annane et al. Cochrane Database Syst Rev 12 (12), CD002243. PMID 31808551. - Review
    Moderate-certainty evidence indicates that corticosteroids probably reduce 28-day and hospital mortality among patients with sepsis. Corticosteroids result in large reduc …
  • Risk Factors of Ventilator-Associated Pneumonia in Elderly Patients Receiving Mechanical Ventilation
    Y Xu et al. Clin Interv Aging 14, 1027-1038. PMID 31289438.
    Purpose: The aim of this study was to verify the potential risk factors of ventilator-associated pneumonia (VAP) in elderly Chinese patients receiving mechanical ventilation (MV). The secondary aim of this study was to present logistical regression prediction models of VAP occurrence in el …
  • Relative Adrenal Insufficiency in Pediatric Septic Shock
    D Vila-Pérez et al. J Pediatr Intensive Care 4 (3), 129-137. PMID 31110862. - Review
    Sepsis and septic shock represent important causes of morbidity and mortality in children, and adrenal dysfunction may play a role in the cardiovascular and immunological …
  • Corticosteroids as Adjunctive Therapy in the Treatment of Influenza
    L Lansbury et al. Cochrane Database Syst Rev 2 (2), CD010406. PMID 30798570. - Meta-Analysis
    We found one RCT of adjunctive corticosteroid therapy for treating people with community-acquired pneumonia, but the number of people with laboratory-confirmed influenza …
  • Immune Effects of Corticosteroids in Sepsis
    N Heming et al. Front Immunol 9, 1736. PMID 30105022. - Review
    Sepsis, a life-threatening organ dysfunction, results from a dysregulated host response to invading pathogens that may be characterized by overwhelming systemic inflammat …
See all "Cited by" articles


    1. Intensive Care Med. 2003 Sep;29(9):1456-63 - PubMed
    1. Am J Respir Crit Care Med. 2003 Feb 15;167(4):512-20 - PubMed
    1. Arch Surg. 1984 Sep;119(9):1021-4 - PubMed
    1. J Immunol. 1985 May;134(5):3307-15 - PubMed
    1. J Am Soc Nephrol. 2001 Feb;12 Suppl 17:S70-4 - PubMed

Publication types