Stress doses of hydrocortisone in septic shock: beneficial effects on opsonization-dependent neutrophil functions

Abstract

In patients with septic shock stress doses of HC exert beneficial effects in terms of improvements in hemodynamics, decrease in pro-inflammatory mediators, and oxidative stress without the compromise of opsonization-dependent phagocytic neutrophil functions; thus, HC treatment does not aggravate non-specific immunosuppression but instead improves innate immunity in the early stage of septic shock.

Hydrocortisone reduces postoperative shivering following day care knee arthroscopy

“…The maximum dose of hydrocortisone was selected as 2 mgÁkg -1 because this dose has been shown to be effective in treating transfusion and drugrelated reactions in the postoperative period. 10 We observed a higher incidence of shivering in the Control group patients (82%) than in earlier studies, 1,2 which may be attributed to two reasons. First, our patients were young and healthy with good muscle mass.…”

“…However, a single low dose (100-200 mg) of hydrocortisone 8,19 is not known to have adverse immunologic or hemodynamic effects. 10,20 Absence of infection and normal wound healing has also been noted in all of the patients given hydrocortisone to reduce inflammation during bilateral total knee replacement. 19 In conclusion, this study demonstrates that hydrocortisone (1-2 mgÁkg -1 iv) provides effective prophylaxis against postoperative shivering in patients undergoing day care knee arthroscopy under general anesthesia.…”

Etomidate increases susceptibility to pneumonia in trauma patients

“…In this setting, patients presenting with Addison disease are more susceptible to infections [31]. Cortisol, a natural hormone, increases neutrophil activity [32,33], preserves monocyte function and increases the homing of dendritic cells [34]. With respect to glucocorticoid therapy, high-dose methylprednisolone and low-dose hydrocortisone display different effects on the immune response [35], and while the former's regimen is immunosuppressive and induces apoptosis of numerous immune cells [36,37], hydrocortisone acts as an immunomodulatory drug [34].…”

“…With respect to glucocorticoid therapy, high-dose methylprednisolone and low-dose hydrocortisone display different effects on the immune response [35], and while the former's regimen is immunosuppressive and induces apoptosis of numerous immune cells [36,37], hydrocortisone acts as an immunomodulatory drug [34]. In comparison to those receiving placebo, low doses of hydrocortisone were found to enhance neutrophil functions [32] and decrease the overwhelming inflammatory response in septic patients [38]. At the same time, interleukin-12 production was increased, whereas interleukin-10 decreased-with no modification of monocytic human leukocyte antigen DR expression.…”

Lipocalina associada à gelatinase de neutrófilos (NGAL) e calprotectina no tecido laminar de equinos após obstrução jejunal, tratados ou não com hidrocortisona

“…Embora os glicocorticóides sejam vistos com ressalvas no tratamento de pacientes críticos, tanto na medicina humana quanto na medicina veterinária, deve-se destacar que a administração deste medicamento em uma única aplicação e baixa dosagem parece ter reduzido o aumento de NGAL nos grupos submetidos à distensão de jejuno. Isto indica que este fármaco possa ser administrado em equinos com afecções agravadas pela ativação sistêmica, com o intuito de coibir seus efeitos deletérios como redução de mediadores inϐlamatórios e do estresse oxidativo (Kaufmann et al 2008). Uma vez comprovada a efetiva participação dos leucócitos na ϐisiopatogenia da laminite, este estudo pode indicar possível papel protetor da integridade laminar do casco.…”