Hydrocortisone and fludrocortisone improved 28-day survival in septic shock and adrenal insufficiency.

I n t e r v e n t i o n All patients received the short corticotropin test (250 μg of tetracosactrin intravenously) for diagnosis of relative adrenal insufficiency (RAI), defined as an increase in cortisol level of ≤ 248.31 nmol/L (9 μg/dL). Subsequently, patients were allocated to treatment with corticosteroids (n = 150 [including in retrospect 114 with RAI]) or placebo (n = 149 [including in retrospect 115 with RAI]). The corticosteroids were a combination of hydrocortisone (50-mg intravenous bolus every 6 h) and fludrocortisone (50-μg tablet/d) for 7 days.