Hemodynamics Effects of Fludrocortisone on the Pressor Response to Noradrenaline Septic Shock Patients
Status:
Not yet recruiting
Trial end date:
2024-04-01
Target enrollment:
Participant gender:
Summary
The benefit of low-dose steroids in septic shock is still debated today, especially with
mineralocorticoids. Fludrocortisone is a synthetic mineralocorticoid, an analogue of
aldosterone, which has shown, in combination with hydrocortisone, a favorable effect on the
mortality of septic shock patients with relative adrenal insufficiency. In a previous study
in healthy volunteers, we showed for the first time that fludrocortisone at a dose of 400 μg
per day significantly improved the pressor response to phenylephrine. These results confirm
the observations reported in rats with endotoxin shock, where fludrocortisone was shown to
significantly increase blood pressure and contractile response to phenylephrine. These
encouraging results argue for a potential vascular beneficial effect of fludrocortisone and
need to be confirmed in a population of septic shock patients. In this context, we aimed to
evaluate the effect of oral administration of 100 μg every 6 hours of fludrocortisone on
vascular responsiveness to noradrenaline in septic shock patients.