.webp&w=384&q=75){kind=logo}
Loading, please wait...
Loading, please wait...
APROCCHSS examined the effect of hydrocortisone plus fludrocortisone in adults with septic shock. In this multicentre, double-blind trial, patients received the corticosteroid combination or placebo as part of a factorial design. The primary outcome was 90-day all-cause mortality. The combination treatment was associated with lower 90-day mortality than placebo, as well as more days alive and free of vasopressors and mechanical ventilation in several analyses. Hyperglycaemia was more frequent with corticosteroid treatment. The study is important because it demonstrated that not all corticosteroid strategies produce identical clinical effects. Compared with the ADRENAL trial, which tested hydrocortisone alone, APROCCHSS raised the possibility that mineralocorticoid activity may influence outcomes in selected patients with septic shock. At the same time, interpretation should remain grounded in the totality of corticosteroid evidence rather than in a single positive trial. The most useful bedside message is that corticosteroids may have a role in vasopressor-dependent shock, but the expected benefit is mainly related to haemodynamic recovery and, depending on regimen and population, possibly mortality. Clinicians should also account for glucose control, muscle weakness and infection-related complications when initiating therapy.
Read summarized clinical updates, watch expert medical content, and earn CME certifications right from your smartphone.
Open your smartphone camera to scan and install.
APROCCHSS examined the effect of hydrocortisone plus fludrocortisone in adults with septic shock. In this multicentre, double-blind trial, patients received the corticosteroid combination or placebo as part of a factorial design. The primary outcome was 90-day all-cause mortality. The combination treatment was associated with lower 90-day mortality than placebo, as well as more days alive and free of vasopressors and mechanical ventilation in several analyses. Hyperglycaemia was more frequent with corticosteroid treatment. The study is important because it demonstrated that not all corticosteroid strategies produce identical clinical effects. Compared with the ADRENAL trial, which tested hydrocortisone alone, APROCCHSS raised the possibility that mineralocorticoid activity may influence outcomes in selected patients with septic shock. At the same time, interpretation should remain grounded in the totality of corticosteroid evidence rather than in a single positive trial. The most useful bedside message is that corticosteroids may have a role in vasopressor-dependent shock, but the expected benefit is mainly related to haemodynamic recovery and, depending on regimen and population, possibly mortality. Clinicians should also account for glucose control, muscle weakness and infection-related complications when initiating therapy.
4 weeks back
A bioengineered oral nanozyme microsupplement converts pathological ROS into a protective polydopamine hydrogel shield. By curbing neutrophil extracellular traps and balancing T cells, this platform outperforms standard 5-ASA in preclinical colitis models, opening new paths for sustained remission.
3 days back
Recent research reveals that downregulating YAP1/TAZ-TEAD via Hippo signaling triggers spontaneous human trophoblast syncytialization in 3D cultures, illuminating placental biology and preeclampsia.
4 weeks back
Abdominal aortic aneurysm rupture remains a catastrophic vascular emergency. Groundbreaking research reveals that USP53 accelerates aneurysm progression by reprogramming smooth muscle cell metabolism toward aerobic glycolysis, highlighting a promising target beyond conventional diameter-based surveillance.
5 days back
A breakthrough study leverages natural language processing to accurately identify incident medication-related osteonecrosis of the jaw and track antiresorptive drug holidays from clinical narratives in electronic health records, advancing osteoporosis pharmacovigilance and dental safety.
4 days back
Recent research defines ferro-aging as a conserved iron-lipid axis driving organ decline across primates. Age-related iron dyshomeostasis stimulates ACSL4-mediated lipid peroxidation, promoting cellular senescence. Notably, vitamin C directly inhibits ACSL4, suppressing phospholipid oxidation and multi-organ decay.
5 days back
