Occurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival

Objective Our aim was to estimate the occurrence of adrenal suppression in critically ill patients with septic shock who have got admission in intensive care unit and to evaluate the effectiveness of hydrocortisone in these patients in relation to mortality of patient, development of septic shock, a...

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Autores principales:	Kamalakanta Swain, Sikata Nanda, Sarat Chandra Jayasingh, Sidharth Sraban Routray, Avijit Swain, Padmalaya Sahoo
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	adrenal suppression sepsis indian population corticosteroid Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/3f7913e528064a76bc3229998971eeda
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spelling	oai:doaj.org-article:3f7913e528064a76bc3229998971eeda2021-11-29T23:31:05ZOccurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival2455-74202455-094910.1055/s-0041-1731916https://doaj.org/article/3f7913e528064a76bc3229998971eeda2021-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731916https://doaj.org/toc/2455-7420https://doaj.org/toc/2455-0949Objective Our aim was to estimate the occurrence of adrenal suppression in critically ill patients with septic shock who have got admission in intensive care unit and to evaluate the effectiveness of hydrocortisone in these patients in relation to mortality of patient, development of septic shock, and effect on total leucocyte count. Methods Serum cortisol was measured in 120 patients with sepsis. Patients with decreased cortisol level were split in to two groups (group A and B). Group A received 50 mg of hydrocortisone 6 hourly and group B was given matching placebo. At day 7, serum cortisol level was estimated for both A and B groups. The results were calculated and compared with relation to incidence of adrenal insufficiency, development of septic shock, effect on total leucocyte count, and survival at 28 days. Results The occurrence of adrenal suppression in patients having sepsis in our study was 44 out of 120 patients, that is, 36.6%. After supplementation of corticosteroid for 7 days the mean value of serum cortisol of group A was 40.38 ± 8.44 µg/dL and group B was 24.30 ± 6.47 µg/dL (p < 0.001). At day 7, in group A, 22.7% developed septic shock, whereas in group B, 36.4% developed septic shock (p < 0.001). In group A and B, mortality rate of the patients at 28 days was 18.2 and 22.7%, respectively. Conclusion Hydrocortisone supplementation in critically ill patients with low random basal serum cortisol level with sepsis does not significantly improve the overall survival.Kamalakanta SwainSikata NandaSarat Chandra JayasinghSidharth Sraban RoutrayAvijit SwainPadmalaya SahooThieme Medical and Scientific Publishers Pvt. Ltd.articleadrenal suppressionsepsisindian populationcorticosteroidOrthopedic surgeryRD701-811ENInternational Journal of Recent Surgical and Medical Sciences, Vol 7, Iss 02, Pp 80-84 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	adrenal suppression sepsis indian population corticosteroid Orthopedic surgery RD701-811
spellingShingle	adrenal suppression sepsis indian population corticosteroid Orthopedic surgery RD701-811 Kamalakanta Swain Sikata Nanda Sarat Chandra Jayasingh Sidharth Sraban Routray Avijit Swain Padmalaya Sahoo Occurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival
description	Objective Our aim was to estimate the occurrence of adrenal suppression in critically ill patients with septic shock who have got admission in intensive care unit and to evaluate the effectiveness of hydrocortisone in these patients in relation to mortality of patient, development of septic shock, and effect on total leucocyte count. Methods Serum cortisol was measured in 120 patients with sepsis. Patients with decreased cortisol level were split in to two groups (group A and B). Group A received 50 mg of hydrocortisone 6 hourly and group B was given matching placebo. At day 7, serum cortisol level was estimated for both A and B groups. The results were calculated and compared with relation to incidence of adrenal insufficiency, development of septic shock, effect on total leucocyte count, and survival at 28 days. Results The occurrence of adrenal suppression in patients having sepsis in our study was 44 out of 120 patients, that is, 36.6%. After supplementation of corticosteroid for 7 days the mean value of serum cortisol of group A was 40.38 ± 8.44 µg/dL and group B was 24.30 ± 6.47 µg/dL (p < 0.001). At day 7, in group A, 22.7% developed septic shock, whereas in group B, 36.4% developed septic shock (p < 0.001). In group A and B, mortality rate of the patients at 28 days was 18.2 and 22.7%, respectively. Conclusion Hydrocortisone supplementation in critically ill patients with low random basal serum cortisol level with sepsis does not significantly improve the overall survival.
format	article
author	Kamalakanta Swain Sikata Nanda Sarat Chandra Jayasingh Sidharth Sraban Routray Avijit Swain Padmalaya Sahoo
author_facet	Kamalakanta Swain Sikata Nanda Sarat Chandra Jayasingh Sidharth Sraban Routray Avijit Swain Padmalaya Sahoo
author_sort	Kamalakanta Swain
title	Occurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival
title_short	Occurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival
title_full	Occurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival
title_fullStr	Occurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival
title_full_unstemmed	Occurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival
title_sort	occurrence of adrenal suppression in patients having sepsis in indian population and impact of corticosteroid supplementation on its overall survival
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/3f7913e528064a76bc3229998971eeda
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Occurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival

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