Hydrocortisone Used To Wean Off Patients from Ventilator FasterPatients who have low levels of adrenal are supposed to be weaned off early from ICU if they are given a supplement of hydrocortisone before extubation is attempted.

Study was conducted on 93 critically ill patients, 91.4% of the 70 with relative adrenal insufficiency who received hydrocortisone infusions were successfully weaned from a ventilator, compared with 68.8% of those who received a saline placebo.

This stress dose corticosteroid supplementation with adrenal insufficiency led to a significantly higher success rate for ventilator weaning. Functional adrenal insufficiency was related to subnormal corticosteroid production during critical illness, particularly septic shock, in the absence of structural defects in the hypothalamic-pituitary-adrenal axis.

The patients were given regular corticosteroids before or during the admission. Patients with adrenal insufficiency were given 50 mg intravenous hydrocortisone every six hours during the weaning period. Studies showed that 32 of 35 patients taking hydrocortisone were successfully taken off ventilators, compared with 24 of 35 in the control group. Among the 20 patients with adequate adrenal reserves, 20 of 20 patients were taken off ventilator, but three failed after extubation.

Studies conclude that the weaning period was shorter in the hydrocortisone treatment group than in the placebo group. They also noted that “No significant adverse effects were observed in the corticosteroid treatment group.”