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Am J Emerg Med. 2007 Mar;25(3):318-25.

The effect of hydrocortisone on the outcome of out-of-hospital cardiac arrest patients: a pilot study.

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  • 1Department of Emergency Medicine, National Taiwan University Hospital and College of Medicine, Taipei 100, Taiwan.

Abstract

OBJECTIVE:

Several studies have disclosed the importance of serum adrenocorticotropic hormone and cortisol levels in resuscitation. The objective of this study was to observe the effect of hydrocortisone on the outcome of out-of-hospital cardiac arrest (OHCA) patients.

DESIGN:

Prospective, nonrandomized, open-labeled clinical trial.

SETTING:

Emergency department (ED) of National Taiwan University Hospital.

PATIENTS AND PARTICIPANTS:

Ninety-seven nontraumatic adult OHCA victims.

INTERVENTIONS:

Serum adrenocorticotropic hormone and total cortisol levels were examined in all patients. The hydrocortisone group (n = 36) received 100 mg intravenous hydrocortisone during resuscitation, and the nonhydrocortisone group (n = 61) received 0.9% saline as placebo.

MEASUREMENTS AND RESULTS:

Comparison of return of the spontaneous circulation (ROSC) rates between the 2 groups was analyzed. The hydrocortisone group had a significantly higher ROSC rate than the nonhydrocortisone group (61% vs 39%, P = .038). Hydrocortisone administration within 6 minutes after ED arrival led to an increased ROSC rate (90% vs 50%, P = .045). The hydrocortisone and nonhydrocortisone groups did not differ in the development of electrolyte disturbances, gastrointestinal tract bleeding, or infection during early postresuscitation period (gastrointestinal bleeding: 41% vs 46%, P = .89; infection: 50% vs 75%, P = .335). There was no significant difference between the hydrocortisone and nonhydrocortisone groups in terms of 1- and 7-day survival and hospital discharge rates.

CONCLUSIONS:

Hydrocortisone treatment during resuscitation, particularly when administrated within 6 minutes of ED arrival, may be associated with an improved ROSC rate in OHCA patients.

PMID:
17349907
[PubMed - indexed for MEDLINE]
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