title: The effect of hydrocortisone on the outcome of out-of-hospital cardiac arrest patients: a pilot study.
abstract: OBJECTIVE
  Several studies have disclosed the importance of serum adrenocorticotropic hormone and cortisol levels in resuscitation. The objective of this study was to observe the effect of hydrocortisone on the outcome of out-of-hospital cardiac arrest (OHCA) patients.
  
  
  METHODS
  Prospective, nonrandomized, open-labeled clinical trial.
  
  
  METHODS
  Emergency department (ED) of National Taiwan University Hospital.
  
  
  METHODS
  Ninety-seven nontraumatic adult OHCA victims.
  
  
  METHODS
  Serum adrenocorticotropic hormone and total cortisol levels were examined in all patients. The hydrocortisone group (n = 36) received 100 mg intravenous hydrocortisone during resuscitation, and the nonhydrocortisone group (n = 61) received 0.9% saline as placebo.
  
  
  RESULTS
  Comparison of return of the spontaneous circulation (ROSC) rates between the 2 groups was analyzed. The hydrocortisone group had a significantly higher ROSC rate than the nonhydrocortisone group (61% vs 39%, P = .038). Hydrocortisone administration within 6 minutes after ED arrival led to an increased ROSC rate (90% vs 50%, P = .045). The hydrocortisone and nonhydrocortisone groups did not differ in the development of electrolyte disturbances, gastrointestinal tract bleeding, or infection during early postresuscitation period (gastrointestinal bleeding: 41% vs 46%, P = .89; infection: 50% vs 75%, P = .335). There was no significant difference between the hydrocortisone and nonhydrocortisone groups in terms of 1- and 7-day survival and hospital discharge rates.
  
  
  CONCLUSIONS
  Hydrocortisone treatment during resuscitation, particularly when administrated within 6 minutes of ED arrival, may be associated with an improved ROSC rate in OHCA patients.
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital and College of Medicine, Taipei 100, Taiwan.
authors.forename: Min-Shan
authors.initials: MS
authors.lastname: Tsai
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Huang
authors.forename: Wei-Tien
authors.initials: WT
authors.lastname: Chang
authors.forename: Wen-Jone
authors.initials: WJ
authors.lastname: Chen
authors.forename: Chiung-Yuan
authors.initials: CY
authors.lastname: Hsu
authors.forename: Cheng-Chun
authors.initials: CC
authors.lastname: Hsieh
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Wen-Chu
authors.initials: WC
authors.lastname: Chiang
authors.forename: Matthew Huei-Ming
authors.initials: MH
authors.lastname: Ma
authors.forename: Shyr-Chyr
authors.initials: SC
authors.lastname: Chen
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006323:Heart Arrest / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D010865:Pilot Projects; D011188:Potassium / Q000097:blood; D012151:Resuscitation / Q000379:methods*; D012964:Sodium / Q000097:blood; D013624:Taiwan
chemical_list: D000893:Anti-Inflammatory Agents; D000324:Adrenocorticotropic Hormone; D012964:Sodium; D011188:Potassium; D006854:Hydrocortisone