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Open Access 01-12-2016 | Letter

Possible significance of hemodynamic and immunomodulatory effects of early stress-dose steroids in cardiac arrest

Authors: Spyros D. Mentzelopoulos, Nicolas Mongardon, Theodoros Xanthos, Spyros G. Zakynthinos

Published in: Critical Care | Issue 1/2016

Excerpt

In an interesting randomized clinical trial (RCT), Donnino et al. [1] studied a mixed out-of-hospital cardiac arrest and in-hospital cardiac arrest (IHCA) population and found no hydrocortisone versus placebo hemodynamic or in-hospital outcome benefit. In the hydrocortisone group, the median time to study intervention was 9.9 h after return of spontaneous circulation (ROSC) [1]. This time lag probably exceeds the therapeutic window for the prevention of detrimental episodes of early post-resuscitation hypotension [2] through a mean arterial pressure (MAP)-stabilizing effect of steroids [3, 4]. …

Donnino MW, Andersen LW, Berg KM, Collaborating authors from the Beth Israel Deaconess Medical Center’s Center for Resuscitation Science Research Group, et al. Corticosteroid therapy in refractory shock following cardiac arrest: a randomized, double-blind, placebo-controlled, trial. Crit Care. 2016;20:82.CrossRefPubMedPubMedCentral

Trzeciak S, Jones AE, Kilgannon JH, et al. Significance of arterial hypotension after resuscitation from cardiac arrest. Crit Care Med. 2009;37:2895–903.CrossRefPubMed

Mentzelopoulos SD, Zakynthinos SG, Tzoufi M, et al. Vasopressin, epinephrine, and corticosteroids for in-hospital cardiac arrest. Arch Intern Med. 2009;169:15–24.CrossRefPubMed

Mentzelopoulos SD, Malachias S, Chamos C, et al. Vasopressin, steroids, and epinephrine and neurologically favourable survival after in-hospital cardiac arrest: a randomized clinical trial. JAMA. 2013;310:270–9.CrossRefPubMed

Vaahersalo J, Skrifvars MB, Pulkki K, et al. Admission interleukin-6 is associated with post resuscitation organ dysfunction and predicts long-term neurological outcome after out-of-hospital ventricular fibrillation. Resuscitation. 2014;85:1573–9.CrossRefPubMed

Title: Possible significance of hemodynamic and immunomodulatory effects of early stress-dose steroids in cardiac arrest
Authors: Spyros D. Mentzelopoulos
Nicolas Mongardon
Theodoros Xanthos
Spyros G. Zakynthinos
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2016
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-016-1384-4

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Possible significance of hemodynamic and immunomodulatory effects of early stress-dose steroids in cardiac arrest

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Keynote webinar | Spotlight on sleep in brain health

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