The Efficacy of Hydrocortisone Combined With Norepinephrine in the Treatment of Severe Septic Shock and Its Effect on Immunoinflammatory Indexes

Abstract

Aims/Background Severe septic shock (SS) is a life-threatening condition characterized by systemic inflammation and organ dysfunction. Hydrocortisone is used to reduce inflammation, while norepinephrine raises blood pressure and supports vasoconstriction, helping to maintain organ perfusion. This study aims to investigate the efficacy of hydrocortisone combined with norepinephrine in the treatment of SS and its effect on immunoinflammatory indexes. Methods A total of 126 patients with severe SS admitted to Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University from December 2020 to December 2023 were retrospectively selected as the study subjects. Patients were divided into control group (n = 67) and observation group (n = 59) according to the treatment given. The control group was treated with norepinephrine, whereas the observation group was treated with hydrocortisone combined with norepinephrine. The clinical efficacy of the treatment given between the two groups was compared. The serum levels of interleukin 6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT) and serum amyloid A (SAA) were compared between the two groups before and after treatment. The occurrence of adverse reactions was compared between the two groups. The clinical prognostic indexes of the two groups were analyzed. Results The total efficacy rate of observation group (93.22%) was significantly higher than that of control group (74.63%) (p = 0.005). After treatment, the levels of CRP, PCT, IL-6 and SAA in both groups were significantly decreased, with the observation group exhibiting significantly lower levels of these inflammatory indexes than the control group (p < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (p > 0.05). After 7 days of treatment, compared with the control group, the observation group showed significantly lower Acute Physiology and Chronic Health Evaluation (APACHE) II score and Sepsis-related Organ Failure Assessment (SOFA) score, required shorter mechanical ventilation time and total emergency intensive care unit (EICU) treatment time, and had lower mortality within 4 weeks (p < 0.05). Conclusion Hydrocortisone combined with norepinephrine holds high degree of efficacy in the treatment of severe SS by alleviating inflammation, improving prognosis and reducing mortality, while maintaining a good safety profile.

Keywords: hydrocortisone; inflammation; norepinephrine; septic shock.