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Internal Medicine

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Do We Need to Administer Fludrocortisone in Addition to Hydr... : Critical Care Medicine (lww.com)


This systematic review and Bayesian network meta-analysis, involving 19 studies and 95,841 patients, assessed hydrocortisone with/without fludrocortisone versus placebo in septic shock. Hydrocortisone plus fludrocortisone was associated with reduced short-term mortality (OR: 0.79; 95% CrI: 0.64-0.99; NNT: 21) compared to placebo, showing potential benefits with minimal adverse events. However, findings suggest cautious interpretation due to low certainty evidence and a broad NNT range, indicating the need for further large-scale RCTs.

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