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Corticosteroid administration is associated with improved outcome of patients presenting high inflammatory cytokine levels during septic shock
Author(s) -
Xu XiaoJun,
Tang YongMin,
Song Hua,
Yang ShiLong,
Xu WeiQun,
Shi ShuWen
Publication year - 2014
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25132
Subject(s) - medicine , septic shock , cytokine , corticosteroid , shock (circulatory) , sepsis , intensive care medicine , immunology
Background This study aimed to investigate the corticosteroid effects on pediatric hematology/oncology patients with septic shock. Procedure We performed a retrospective study by examining data from a prospective observational study in pediatric hematology/oncology patients with septic shock. We compared the clinical features and the outcomes of the patients treated with and without corticosteroid. Results One hundred episodes of septic shock were recorded in this study. The 28‐day mortality of this cohort was 14.0%. Sixty‐eight episodes of shock were treated with corticosteroids while 32 were not. The demographic features and disease severity were comparable between patients with and without corticosteroid treatment. Corticosteroid therapy was associated with improved shock reversal rate (92.6% vs. 78.1%, P = 0.049) and decreased 28‐day mortality rate (8.8 ± 3.4% vs. 25.0 ± 7.7%, P = 0.032) in univariate analysis. For patients who received vasopressor support, corticosteroid therapy was associated with shortened duration of vasopressor infusion in univariate analysis as well (median: 44 hour vs. 92 hour, P = 0.035). In multivariate analysis, corticosteroid therapy did not show significant impact on the outcome for the whole cohort (HR = 0.36, P = 0.079), but it decreased the 28‐day mortality of patients presenting high inflammatory cytokine levels (HR = 0.29, 95% CI, 0.09–0.95, P = 0.040). Corticosteroid administration did not increase the superinfection rate (24.2% vs. 8.3%, P = 0.134) and did not result in superinfection‐related death in this cohort. Conclusions Corticosteroid administration is associated with improved outcome in pediatric hematology/oncology patients presenting high inflammatory cytokine levels during septic shock. Pediatr Blood Cancer 2014;61:2243–2248. © 2014 Wiley Periodicals, Inc.