An Evaluative Comparison of Continuous Versus Intermittent Hydrocortisone Administration in the Therapeutic Approach to Septic Shock

Research Article
An Evaluative Comparison of Continuous Versus Intermittent Hydrocortisone Administration in the Therapeutic Approach to Septic Shock

International Journal of Pharmacology, 2024, 20(5), 832-840.

Abstract

Background and Objective: The pathophysiology of septic shock is intricately associated with immune dysregulation and inflammatory responses. Hydrocortisone inhibits excessive inflammation, but optimal dosage and administration methods remain debated. This study purports to appraise and juxtapose the therapeutic efficacies of continuous and intermittent hydrocortisone administration regimens in managing septic shock. Materials and Methods: A retrospective scrutiny of clinical data was performed involving 73 patients diagnosed with septic shock from March, 2019 to February, 2022. The patients were dichotomized into two groups: The continuous group (administered with an unremitting intravenous infusion of hydrocortisone) and the intermittent group (treated with sporadic slow intravenous drips of hydrocortisone), comprising 40 and 33 cases, respectively. The MBG, LAGE, hyperglycemic time window and GV were significantly diminished in the continuous group vis-à-vis the intermittent group, with the differences bearing statistical significance (p<0.05). Results: Relative to pre-treatment values, PCT, hs-CRP, IL-1β, IL-6, TNF-α and HMGB-1 concentrations were significantly reduced in both groups at the 96 hrs treatment mark and were lower in the continuous group (p<0.05). Relative to pre-treatment values, CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were significantly elevated in both groups at the 96 hrs treatment mark and were higher in the continuous group, while CD8⁺ was significantly reduced and was lower in the continuous group (p<0.05). Conclusion: Compared with intermittent hydrocortisone administration, continuous hydrocortisone treatment demonstrated superior efficacy in managing septic shock. The continuous regimen notably mitigated blood glucose variability, regulated oxygen metabolism, suppressed inflammatory responses and enhanced immune functionality. However, it presented no significant advantages concerning hemodynamic parameters and short-term prognostic indices.

ASCI-ID: 23-2035

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