Most Read Articles
Roshini Claire Anthony, 3 days ago

The addition of methylprednisolone to standard care* reduced mortality risk in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF), according to a study from China.

05 Feb 2021

Primary immunodeficiency disease (PIDD) and allergies are two groups of conditions related to the immune system. However, they are uniquely different in terms of symptoms and treatment.

Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Stephen Padilla, 3 days ago
High-flow oxygen is not associated with an increase or a decrease in 30-day mortality, suggesting no benefit in most patients presenting with a suspected acute coronary syndrome (ACS), reports a New Zealand study.

Hydrocortisone continuous infusion for septic shock shows no positive impact on glycaemic control

22 Feb 2021

Continuous infusion (CI) hydrocortisone therapy in patients with septic shock is not associated with a beneficial impact on mean blood glucose or influence glycaemic variability as compared to bolus dose (BD) therapy, reports a study.

“Corticosteroid therapy in patients with septic shock can improve haemodynamics but can also cause hyperglycaemia,” the authors said. “CI hydrocortisone has limited evidence that it may reduce hyperglycaemia relative to BD therapy, but CI can be cumbersome and requires attention to intravenous access and drug incompatibilities.”

To compare the effects of CI hydrocortisone with BD on glycaemic control, the authors carried out a matched, retrospective cohort study of blood glucose, insulin requirements, and glycaemic variability between patients with shock receiving CI and BD hydrocortisone. They matched participants according to their history of type 2 diabetes and intensive care unit (ICU) admission.

Baseline blood glucose was comparable between the CI and BD groups, with the former having higher baseline hourly insulin requirements (12 vs 7 units; p=0.0012). There was no difference in mean blood glucose for the first 72 hours of treatment, with higher average hourly insulin requirement in the CI vs the BD group (7.8 vs 5.5 units; p<0.0001).

In addition, no between-group difference was observed in glycaemic variability.

A 2007 trial reported that CI hydrocortisone therapy for septic shock could help patients more easily achieve strict normoglycaemia. This approach also reduced nursing workload needed to maintain tight blood glucose control. [Crit Care 2007;11:R21]

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, 3 days ago

The addition of methylprednisolone to standard care* reduced mortality risk in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF), according to a study from China.

05 Feb 2021

Primary immunodeficiency disease (PIDD) and allergies are two groups of conditions related to the immune system. However, they are uniquely different in terms of symptoms and treatment.

Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Stephen Padilla, 3 days ago
High-flow oxygen is not associated with an increase or a decrease in 30-day mortality, suggesting no benefit in most patients presenting with a suspected acute coronary syndrome (ACS), reports a New Zealand study.