ClinicalTrials.gg
RecruitingNCT05818826CESSHYDROUpdated Apr 5, 2024

Early Versus Conventional Cessation of Hydrocortisone in Septic Shock

A Phase 2 interventional study of normal saline solution and Hydrocortisone and normal saline solution in Septic Shock, Adverse Event and Hydrocortisone, sponsored by Mahidol University. Recruiting at 1 site in Thailand. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-04-05.

Sponsored by Mahidol University · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Apr 2025, 1 year 7 months ago, but the record still lists the study as recruiting.
  • Started Jul 2023; still recruiting 3 years 4 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Septic shock is one of the causes of death in ICU and hospital. Refractory shock is the problem which healthcare providers should recognize though it is difficult to handle with. The corticosteroid called hydrocortisone is one of the treatment in refractory septic shock which requires vasopressor to maintain blood pressure. In recovery phase of septic shock and weaning off vasopressor, there is no definite way to taper off hydrocortisone.

Read the detailed description

According to secondary outcomes of several studies analyzed in systemic review was shown adverse events from corticosteroid uses including hyperglycemia, hypernatremia, muscle weakness, and superimposed infection. This trials will compare composite adverse events in early versus conventional cessation of hydrocortisone in septic shock.

02

Conditions studied

  • Septic Shock
  • Adverse Event
  • Hydrocortisone
  • Hyperglycemia
  • Hypernatremia
  • Muscle Weakness
  • Superimposed Infection

Keywords

  • septic shock
  • composite adverse events
  • hydrocortisone
  • hyperglycemia
  • hypernatremia
  • muscle weakness
  • superimposed infection
03

In context

Shock, Septic

1,078 studies on the registry are indexed under Shock, Septic; 232 are open to participants now.

This study's planned enrollment of 160 is above the median of 79 across 636 interventional studies indexed under Shock, Septic.

Browse Shock, Septic studies →

Lead sponsor

Mahidol University is the lead sponsor of 747 studies on the registry; 119 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patient >= 18 years old
  • Diagnosis Septic shock from the definition of SEPSIS III criteria in intensive care unit or medicine ward or surgical ward at Siriraj hospital
  • Received at least 1 catecholamines and hydrocortisone at least 200 mg/d
  • Maintain mean arterial pressure >= 65 mmHg even if titrate down catecholamines until low dose (\<=0.1 mcg/kg/min)

Exclusion criteria

Exclusion Criteria:

  • Patient sign Do not resuscitation and terminally ill
  • Pregnancy
  • Need long term use due to other medical condition
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
160 participants (estimated)

Study arms

  • Experimental
    early cessation group

    The pharmacist uses 100 ml of normal saline solution, packed out in the same format, dose, and administration of the drug were exactly the same as in the conventional cessation group. The experimental starts after required dose of vasopressor less than 0.1 mcg/kg/min. The nurse serially records capillary blood glucose and serum sodium following the doctor's order.

    Drug: normal saline solution

  • Placebo comparator
    conventional cessation group

    The pharmacist prepared hydrocortisone and normal saline solution 100 ml starts dose at least 200 mg/day according to doctor's order after patient meets the criteria of refractory septic shock then continues conventional cessation of hydrocortisone according to doctor's order after required dose of vasopressor less than 0.1 mcg/kg/min. The nurse serially records capillary blood glucose and serum sodium following the doctor's order.

    Drug: Hydrocortisone and normal saline solution

Interventions

  • Drugnormal saline solution

    Prepare 100 ml of normal saline solution, packed out in the same format, dose, and administration of the drug were exactly the same as in the conventional cessation group.

    Also known as: early cessation group

  • DrugHydrocortisone and normal saline solution

    Prepare hydrocortisone with normal saline solution 100 ml starts dose at least 200 mg/day according to doctor's order after patient meets the criteria of refractory septic shock then continues conventional cessation of hydrocortisone according to doctor's order after required dose of vasopressor less than 0.1 mcg/kg/min.

    Also known as: conventional cessation group

06

What researchers measure

Primary outcomes

  1. Composite adverse events of early versus conventional cessation of hydrocortisone

    including level of capillary blood glucose \>= 180mg/dL(Hyperglycemia) , Plasma level of sodium\>= 150mmol/L(Hypernatremia), new onset of infection , and neuromuscular weakness(muscular impairment rating scale\>1

    Time frame: within 14 days after randomization or until discharge from hospital, whichever came first

Secondary outcomes

  1. Number of participants with 28-day mortality from any cause or until discharge from hospital

    death from any cause until 28-day after randomization or until discharge from hospital

    Time frame: 28-day mortality from any cause start until 28 day after randomization or until discharge from hospital, whichever came first

  2. Concentration of insulin needed due to hyperglycemia

    Total insulin used to lower capillary blood sugar if level of glucose more than 180 mg/dL

    Time frame: within 14 days after randomization or until discharge from hospital, whichever came first

  3. Number of participants with hypoglycemia

    Number of participants with capillary blood glucose \< 80 mg/dL

    Time frame: within 14 days after randomization or until discharge from hospital, whichever came first

  4. Number of participants with capillary blood glucose ≥ 150 mg/dL

    Number of participants with capillary blood glucose ≥ 150 mg/dL

    Time frame: within 14 days after randomization or until discharge from hospital, whichever came first

  5. Time of vasopressor reinitiation until 14 day after randomization or until hospital discharge

    Duration measured as hours from off vasopressor until re-initiation at least 0.05 mcg/kg/min until 14 day after randomization or until hospital discharge

    Time frame: within 14 days after randomization or until discharge from hospital, whichever came first

  6. Time to need of fluid bolus

    Duration measured as hours from randomization until fluid bolus at least 250 ml in 10-15 minutes until 14 day after randomization or until hospital discharge

    Time frame: within 14 days after randomization or until discharge from hospital, whichever came first

  7. Time to reversal of shock

    Duration measured as hours from randomization until off vasopressor

    Time frame: within 14 days after first dose of hydrocortisone or until discharge from hospital, whichever came first

  8. Number of participants with New onset of infection within 28 days

    Number of participants with New onset of infection within 28 days

    Time frame: 28 days

  9. Duration of ICU length of stay

    Duration measured as days from randomization until discharge from ICU

    Time frame: 14 days after first dose hydrocortisone or until discharge from hospital, whichever came first

  10. Duration of Ventilator free day

    Duration measured as hours from off ventilator until on ventilator or reintubation

    Time frame: 14 days after first dose hydrocortisone or until discharge from hospital, whichever came first

  11. Number of participants with Lung injury score at day 1, day 3, day 7 after first dose hydrocortisone

    Number of participants with Lung injury score at day1, day3, day7 after first dose hydrocortisone

    Time frame: 7 days after randomization or until discharge from hospital, whichever came first

  12. Level of minimum and maximum mean arterial pressure

    Level of minimum and maximum mean arterial pressure until 14 days after randomization or until hospital discharge

    Time frame: within 14 days after randomization or until discharge from hospital, whichever came first

  13. Number of participants with Alive days in 28 days with free mechanical ventilator

    Number of participants who survive in 28 days with free mechanical ventilator

    Time frame: 28 days after randomization or until discharge from hospital, whichever came first

  14. Number of participants with Alive days in 28 days with free renal replacement therapy

    Number of participants who survive in 28 days with free mechanical ventilator

    Time frame: 28 days after randomization or until discharge from hospital, whichever came first

  15. Number of participants with Alive days in 28 days with free organ supports

    Number of participants who survive in 28 days with free mechanical ventilator

    Time frame: 28 days after randomization or until discharge from hospital, whichever came first

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: Yes — Anonymous identification data will be prepared per request, after study publication 6 months

Supporting information: Study protocol, Statistical analysis plan, Clinical study report, Analytic code

Time frame: 6 months post study publication

Access criteria: Request to principal investigation, after protocol approval from ethical committee

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jul 2023 (actual). Primary completion is estimated for Apr 2025, 21 months after the start.

Of 36 non-industry phase 2 interventional studies under Shock, Septic, half reached primary completion within 29 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 42. This study's planned 21 months is below that.

Counting every sponsor, half of 41 studies reached it within 29 months; a quarter within 15 and three quarters within 42.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 19, 2023
First posted
Apr 19, 2023
StartActual
Jul 5, 2023
Primary completionEst.
Apr 2025
CompletionEst.
May 2025
Last update
Apr 5, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 5, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05818826
Lead sponsor
Mahidol University
Responsible party
Sponsor
First posted
Apr 19, 2023
Start date
Jul 5, 2023
Primary completion
Apr 2025 (estimated)
Completion
May 2025 (estimated)
Last update
Apr 5, 2024

Study contacts

Surat Tongyoo, Doctor
Contact
surat.ton@mahidol.ac.th
+24197764
Kolanya Kangwanyotsak, Doctor
Contact
tkolanya@hotmail.com
+24197764
Surat Tongyoo, Doctor
principal investigator · Mahidol University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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