Mohammed Aldhaeefi, Abdulrahman Alshaya, Sanaa Belrhiti, Dhakrit Rungkitwattanakul
{"title":"Alternatives to Hydrocortisone for Hemodynamic Support in Septic Shock Management Due to Medication Shortage.","authors":"Mohammed Aldhaeefi, Abdulrahman Alshaya, Sanaa Belrhiti, Dhakrit Rungkitwattanakul","doi":"10.1097/CCE.0000000000000940","DOIUrl":null,"url":null,"abstract":"<p><p>Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Septic shock is when initial fluid resuscitation fails to increase the mean atrial pressure to greater than or equal to 65 mm Hg. The 2021 Surviving Sepsis Campaign guidelines recommend corticosteroids for vasopressor and fluid-refractory septic shock patients. Medication shortages can arise, and their etiologies include natural disasters, quality control issues, and manufacturing discontinuation. The U.S. Food and Drug Administration and the American Society of Health-System Pharmacists announced a shortage of IV hydrocortisone. Methylprednisolone and dexamethasone are considered therapeutic alternatives to hydrocortisone. This commentary aims to guide clinicians on the alternative to hydrocortisone among septic shock patients due to medication shortage.</p>","PeriodicalId":10759,"journal":{"name":"Critical Care Explorations","volume":"5 7","pages":"e0940"},"PeriodicalIF":0.0000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/4e/cc9-5-e0940.PMC10292733.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care Explorations","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/CCE.0000000000000940","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Septic shock is when initial fluid resuscitation fails to increase the mean atrial pressure to greater than or equal to 65 mm Hg. The 2021 Surviving Sepsis Campaign guidelines recommend corticosteroids for vasopressor and fluid-refractory septic shock patients. Medication shortages can arise, and their etiologies include natural disasters, quality control issues, and manufacturing discontinuation. The U.S. Food and Drug Administration and the American Society of Health-System Pharmacists announced a shortage of IV hydrocortisone. Methylprednisolone and dexamethasone are considered therapeutic alternatives to hydrocortisone. This commentary aims to guide clinicians on the alternative to hydrocortisone among septic shock patients due to medication shortage.
败血症是一种危及生命的器官功能障碍，由宿主对感染的反应失调引起。脓毒性休克是指最初的液体复苏未能使平均心房压升高到大于或等于65 mm Hg。2021年存活脓毒症运动指南推荐对血管加压和液体难治性脓毒性休克患者使用皮质类固醇。可能出现药物短缺，其原因包括自然灾害、质量控制问题和生产中断。美国食品和药物管理局和美国卫生系统药剂师协会宣布静脉注射氢化可的松短缺。甲基强的松龙和地塞米松被认为是氢化可的松的治疗选择。这篇评论的目的是指导临床医生替代氢化可的松脓毒性休克患者由于药物短缺。
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