
Loading, please wait...

Loading, please wait...

The CORTICUS randomised trial examined low-dose hydrocortisone in adults with septic shock. The study was designed to test whether corticosteroids could improve survival, particularly in patients who did not respond normally to corticotropin stimulation. Hydrocortisone accelerated improvement in measures of organ dysfunction and cardiovascular instability, but the trial did not show a significant mortality benefit. The findings were important because they separated faster haemodynamic recovery from improved survival. That distinction remains clinically useful. Steroids may shorten the duration of shock in selected patients, but their use involves trade-offs such as hyperglycaemia, neuromuscular weakness and infection risk. Modern sepsis practice therefore focuses on who remains vasopressor-dependent and how severe the shock is rather than treating every septic patient with corticosteroids. CORTICUS complements more contemporary steroid trials and is directly relevant to CritiCARE sessions on steroid use, vasopressor dependence and sepsis beyond the guidelines. For HCPs, the practical message is to define the clinical objective before starting corticosteroids: faster shock resolution is a different endpoint from mortality reduction. Treatment decisions should be based on the patient's haemodynamic state, timing and contraindications, with careful monitoring for adverse effects.

Read summarized clinical updates, watch expert medical content, and earn CME certifications right from your smartphone.


The CORTICUS randomised trial examined low-dose hydrocortisone in adults with septic shock. The study was designed to test whether corticosteroids could improve survival, particularly in patients who did not respond normally to corticotropin stimulation. Hydrocortisone accelerated improvement in measures of organ dysfunction and cardiovascular instability, but the trial did not show a significant mortality benefit. The findings were important because they separated faster haemodynamic recovery from improved survival. That distinction remains clinically useful. Steroids may shorten the duration of shock in selected patients, but their use involves trade-offs such as hyperglycaemia, neuromuscular weakness and infection risk. Modern sepsis practice therefore focuses on who remains vasopressor-dependent and how severe the shock is rather than treating every septic patient with corticosteroids. CORTICUS complements more contemporary steroid trials and is directly relevant to CritiCARE sessions on steroid use, vasopressor dependence and sepsis beyond the guidelines. For HCPs, the practical message is to define the clinical objective before starting corticosteroids: faster shock resolution is a different endpoint from mortality reduction. Treatment decisions should be based on the patient's haemodynamic state, timing and contraindications, with careful monitoring for adverse effects.
Today

The phase 3 ACACIA-HCM trial reveals that aficamten improves cardiac structure, diastolic relaxation, functional capacity, and symptom burden in symptomatic nonobstructive hypertrophic cardiomyopathy, marking a major milestone in targeted myosin inhibition.
6 days back

A clinical study shows that automated breast ultrasound paired with artificial intelligence accurately classifies BIRADS 3-4 lesions, reaching 95% sensitivity and 79% specificity. This diagnostic advance promises to reduce unnecessary core needle biopsies and refine clinical workflows in breast imaging.
3 weeks back

Researchers have engineered freestanding hierarchical-porous BCZT thin films that resist cracking and enhance ultrasonic energy harvesting in soft tissue. Achieving high piezoelectric output and acoustic matching, this lead-free material offers transformative potential for implantable bioelectronics.
6 days back

A novel pathology-adaptive surface engineering strategy uses functionalized plasma polymer coatings to selectively modulate AGE adsorption, reducing oxidative stress and restoring bone formation in diabetic and aging microenvironments.
3 weeks back

A breakthrough study identifies the Klotho/PKCα/CUX1/SPARC/TGFβ-RII axis as a critical driver of podocyte mitochondrial injury and ferroptosis in diabetic kidney disease, unveiling promising molecular targets to halt renal disease progression.
6 days back