Failure of hydrocortisone to affect outcome in dengue shock syndrome
- PMID: 7054760
Failure of hydrocortisone to affect outcome in dengue shock syndrome
Abstract
Despite the absence of a clear-cut rationale for their use, corticosteroids are widely employed in the treatment of dengue shock syndrome. Previous comparative therapeutic trials have yielded contradictory results. Resolution of this therapeutic controversy has been attempted with a double-blind evaluation of the clinical effect of steroid administration in dengue shock syndrome. Placebo or a single dose of hydrocortisone hemisuccinate, 50 mg/kg of body weight, was administered randomly to 97 physiologically treated patients with dengue shock syndrome. The severity of disease on admission to the hospital and the effectiveness of treatment were quantified by a World Health Organization scoring system. The response to therapy as measured by mortality, duration of shock, and amount of replacement fluids required was virtually identical in 47 children who were and 50 children who were not treated with steroids. The comparison groups were composed of children similar in age, sex, and severity of illness. It is concluded that hydrocortisone is of no value in the treatment of dengue shock syndrome. Reliance should be placed on appropriate supportive and physiologic therapy.
Similar articles
-
Failure of high-dose methylprednisolone in established dengue shock syndrome: a placebo-controlled, double-blind study.Pediatrics. 1993 Jul;92(1):111-5. Pediatrics. 1993. PMID: 8516054 Review.
-
The role of steroids in dengue shock syndrome.Southeast Asian J Trop Med Public Health. 1987 Sep;18(3):383-9. Southeast Asian J Trop Med Public Health. 1987. PMID: 3324364 Clinical Trial. No abstract available.
-
Hydrocortisone in the management of dengue shock syndrome.Southeast Asian J Trop Med Public Health. 1975 Dec;6(4):573-9. Southeast Asian J Trop Med Public Health. 1975. PMID: 131976 Clinical Trial.
-
Aggressive management of dengue shock syndrome may decrease mortality rate: a suggested protocol.Pediatr Crit Care Med. 2005 Jul;6(4):412-9. doi: 10.1097/01.PCC.0000163676.75693.BF. Pediatr Crit Care Med. 2005. PMID: 15982427
-
Corticosteroids in the treatment of dengue illness.Trans R Soc Trop Med Hyg. 2009 Feb;103(2):122-6. doi: 10.1016/j.trstmh.2008.07.022. Epub 2008 Sep 11. Trans R Soc Trop Med Hyg. 2009. PMID: 18789467 Review.
Cited by
-
Pediatric sepsis: challenges and adjunctive therapies.Crit Care Clin. 2013 Apr;29(2):203-22. doi: 10.1016/j.ccc.2012.11.003. Epub 2013 Jan 3. Crit Care Clin. 2013. PMID: 23537672 Free PMC article. Review.
-
Is "rescue" therapy ethical in randomized controlled trials?Pediatr Crit Care Med. 2009 Jul;10(4):431-8. doi: 10.1097/PCC.0b013e318198bd13. Pediatr Crit Care Med. 2009. PMID: 19307815 Free PMC article. Review.
-
Corticosteroids for dengue - why don't they work?PLoS Negl Trop Dis. 2013 Dec 12;7(12):e2592. doi: 10.1371/journal.pntd.0002592. eCollection 2013. PLoS Negl Trop Dis. 2013. PMID: 24349598 Free PMC article. Clinical Trial.
-
Corticosteroids for dengue infection.Cochrane Database Syst Rev. 2014 Jul 1;2014(7):CD003488. doi: 10.1002/14651858.CD003488.pub3. Cochrane Database Syst Rev. 2014. PMID: 24984082 Free PMC article. Review.
-
Effectiveness of corticosteroid in the treatment of dengue - A systemic review.Heliyon. 2018 Sep 22;4(9):e00816. doi: 10.1016/j.heliyon.2018.e00816. eCollection 2018 Sep. Heliyon. 2018. PMID: 30258999 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Medical