Question special
Resident

Based upon new evidence in APROCCHSS study and prior studies, it appears only trials with hydrocortisone/fludrocortisone have shown a mortality benefit and not hydrocortisone independently. I know Polito et al (2016) have demonstrated some inter-individual variability in plasma fludrocortisone level, but are there any plausible mechanisms to explain a mineralocorticoid benefit in septic shock?