Fludrocortisone in septic shock: revisiting the potential role of mineralocorticoid supplementation

Thanh Luan Nguyen

Emergency and Critical Care Medicine ›› 2026, Vol. 6 ›› Issue (3) : 128

PDF (397KB)
Emergency and Critical Care Medicine ›› 2026, Vol. 6 ›› Issue (3) :128 DOI: 10.1097/EC9.0000000000000203
Emergency and Critical Care Medicine Perspective/Viewpoint
research-article
Fludrocortisone in septic shock: revisiting the potential role of mineralocorticoid supplementation
Author information +
History +
PDF (397KB)

Cite this article

Download citation ▾
Thanh Luan Nguyen. Fludrocortisone in septic shock: revisiting the potential role of mineralocorticoid supplementation. Emergency and Critical Care Medicine, 2026, 6 (3) : 128 DOI:10.1097/EC9.0000000000000203

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021; 47(11): 1181-1247. doi: 10.1007/s00134-021-06506-y

[2]

Annane D, Renault A, Brun-Buisson C, et al; CRICS-TRIGGERSEP Network. Hydrocortisone plus fludrocortisone for adults with septic shock. N Engl J Med. 2018; 378(9): 809-818. doi: 10.1056/NEJMoa1705716

[3]

Bosch NA, Teja B, Law AC, Pang B, Jafarzadeh SR, Walkey AJ. Comparative effectiveness of fludrocortisone and hydrocortisone vs hydrocortisone alone among patients with septic shock. JAMA Intern Med. 2023; 183(5): 451-459. doi: 10.1001/jamainternmed.2023.0258

[4]

Teja B, Berube M, Pereira TV, et al. Effectiveness of fludrocortisone plus hydrocortisone versus hydrocortisone alone in septic shock: a systematic review and network meta-analysis of randomized controlled trials. Am J Respir Crit Care Med. 2024; 209(10): 1219-1228. doi: 10.1164/rccm.202310-1785OC

[5]

Nethathe GD, Lipman J, Anderson R, Fuller PJ, Feldman C. Glucocorticoids with or without fludrocortisone in septic shock: a narrative review from a biochemical and molecular perspective. Br J Anaesth. 2024; 132(1): 53-65. doi: 10.1016/j.bja.2023.10.034

[6]

Annane D, Pastores SM, Rochwerg B, et al. Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017. Crit Care Med. 2017; 45(12): 2078-2088. doi: 10.1097/CCM.0000000000002737

[7]

Annane D, Sébille V, Charpentier C, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002; 288(7): 862-871. doi: 10.1001/jama.288.7.862

[8]

Walsham J, Hammond N, Blumenthal A, et al. Fludrocortisone dose-response relationship in septic shock: a randomised phase II trial. Intensive Care Med. 2024; 50(12): 2050-2060. doi: 10.1007/s00134-024-07616-z

[9]

Funder JW. Aldosterone and mineralocorticoid receptors-physiology and pathophysiology. Int J Mol Sci. 2017; 18(5): 1032. doi: 10.3390/ijms18051032

[10]

Joffre J, Hellman J, Ince C, Ait-Oufella H. Endothelial responses in sepsis. Am J Respir Crit Care Med. 2020; 202(3): 361-370. doi: 10.1164/rccm.201910-1911TR

[11]

Antcliffe DB, Burnham KL, Al-Beidh F, et al. Transcriptomic signatures in sepsis and a differential response to steroids. From the VANISH randomized trial. Am J Respir Crit Care Med. 2019; 199(8): 980-986. doi: 10.1164/rccm.201807-1419OC

[12]

Annane D, Cariou A, Maxime V, et al; COIITSS Study Investigators. Corticosteroid treatment and intensive insulin therapy for septic shock in adults: a randomized controlled trial. JAMA. 2010; 303(4): 341-348. doi: 10.1001/jama.2010.2

[13]

Pitre T, Drover K, Chaudhuri D, et al. Corticosteroids in sepsis and septic shock: a systematic review, pairwise, and dose-response meta-analysis. Crit Care Explor. 2024; 6(1): e1000. doi: 10.1097/CCE.0000000000001000

[14]

Antcliffe DB, Burrell A, Boyle AJ, Gordon AC, McAuley DF, Silversides J. Sepsis subphenotypes, theragnostics and personalized sepsis care. Intensive Care Med. 2025; 51(4): 756-768. doi: 10.1007/s00134-025-07873-6

PDF (397KB)

12

Accesses

0

Citation

Detail

Sections
Recommended

/

〈 〉