Critical illness–related corticosteroid insufficiency after acute brain hemorrhage surgery: a prospective cohort study with a randomized trial of hydrocortisone : HYdrocortisone theraPy in nEurocRitical illness; HYPER study
Authors' conclusion
CIRCI is common in postoperative patients with acute brain hemorrhage and is associated with specific clinical risk factors. Although targeted hydrocortisone therapy did not significantly improve functional outcomes at 30 days, it yielded significant improvements in short-term ICU parameters.
Study context
- Population
- Adults 18–80 years after neurological surgery for acute brain hemorrhage (traumatic or non-traumatic) within 48 h of admission, tertiary care hospitals64 with critical illness-related corticosteroid insufficiency (CIRCI) randomised
- Participants
- 255 adults
- Comparison
- IV hydrocortisone vs placebo in patients with CIRCI
- Primary endpoint
- Neurological improvement (modified Rankin Scale)
- Follow-up
- 30 days
Methodological detailsmulticentre, single-blinded
- Multicentre
- Single-blinded
Primary result
As reported in the abstract
30-day neurological function (modified Rankin Scale (mRS))
- Hydrocortisone did not significantly improve 30-day neurological function
Further findings
Mechanical ventilation duration
P = 0.032
ICU LOS
P = 0.038
CIRCI incidence
- CIRCI diagnosed (n = 64)
- 25.1%
- Cohort
Independent predictors of CIRCI
- Traumatic subdural hematoma, epidural hematoma, mechanical ventilation, FFP transfusion
Safety
- No increase in serious adverse events
Original publication
Critical illness–related corticosteroid insufficiency after acute brain hemorrhage surgery: a prospective cohort study with a randomized trial of hydrocortisone : HYdrocortisone theraPy in nEurocRitical illness; HYPER study. Crit Care. Published 24 February 2026. doi:10.
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