Impact of Hydrocortisone Administration on White Blood Cell Gene Expression in Patients With Severe Sepsis

• Status: Completed
• Trial end date: 2006-11-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this pilot study is to (1) examine the changes in gene expression in patients who suffer from severe sepsis and whose shock (inadequate oxygen delivery to vital organs) state does not respond to fluid and vasopressor administration, (2) to show that our sampling method of isolating RNA provides reliable and consistent data, (3) provide a basis for future gene expression studies in critically ill patients

• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Stanford University
• Collaborators: University of Colorado, Denver; University of Toronto
• Treatments: Cortisol succinate; Hydrocortisone; Hydrocortisone 17-butyrate 21-propionate; Hydrocortisone acetate

Criteria

Inclusion Criteria:

• Admission Diagnosis of Sepsis

• Evidence of Relative Adrenal Insufficiency

• Hypotension (Mean Arterial Pressure less than 60 mm Hg) Refractory to a. Fluid Resuscitation b. Dopamine infusion (greater than 5 micrograms/kg/min) c. Phenylephrine infusion (greater than 1 microgram/kg/min)

Exclusion Criteria:

• Use of Immunosuppressant Medications

• Immune Compromised Due to Disease (e.g., HIV infection)

• Transfusion of Blood Products within the past 7 Days

• Use of Cytokine Therapy (i.e., G-CSF)

• History of Bone Marrow Transplantation