Please select the eligibility criteria that correspond to the clinical trial below.
Title: Low-dose Hydrocortisone in the Treatment of the Shock of Burned Patients
Brief Summary: Major burns trigger the release of circulating mediators, as cytokines and endotoxin that induces a systemic inflammatory response syndrome. The cardiovascular effects are similar to those seen in septic shock. After the initial hypovolemic phase, patients with extensive burns often present a shock with increased cardiac output and reduced systemic vascular resistances. As described in septic shock, we test the hypothesis that low-dose hydrocortisone could decrease the duration of the shock period.


Options:
A: Inclusion Criteria:

1. Aged 18 years or older
2. Documented site of infection, or strong suspicion of infection, with 2 of the 4 clinical signs of inflammation:

   * Core temperature \> 38°C or \< 35°C
   * Heart rate \> 90 beats per minute
   * White cell count \> 12 x 109/L or \< 4 x 109/L or \> 10% immature neutrophils
   * Respiratory rate \> 20 breaths per minute, or PaCO2 \< 32 mmHg, or mechanical ventilation.
3. Being treated with mechanical ventilation at the time of randomisation
4. Being treated with vasopressors or inotropes to maintain a systolic blood pressure \> 90mmHg, or mean arterial blood pressure \> 60mmHg, or a MAP target set by the treating clinician for maintaining perfusion
5. Administration of vasopressors or inotropes for = 4 hours and present at time of randomisation.

Exclusion Criteria:

1. Met all inclusion criteria more than 24 hours ago
2. Clinician expects to prescribe systemic corticosteroids for an indication other than septic shock (not including nebulised or inhaled corticosteroid)
3. Patients treated with etomidate
4. Patients receiving treatment with Amphotericin B for systemic fungal infections at time of randomisation
5. Patients with documented cerebral malaria at the time of randomisation
6. Patients with documented strongyloides infection at the time of randomisation
7. Death is deemed inevitable or imminent during this admission and either the attending physician, patient or surrogate legal decision maker is not committed to active treatment
8. Death from underlying disease is likely within 90 days
9. Patient has been previously enrolled in the ADRENAL study.
B: Inclusion Criteria:

* males and females,
* between 18 and 75 year old
* who present a burned surface more than 30% of the body surface
* who need catecholamine infusion
* between J0 and J3 after the injury.

Exclusion Criteria:

* pregnancy,
* trauma,
* sepsis,
* cardiac insufficiency,
* AIDS,
* etomidate administration
C: Inclusion Criteria:

1. age 18 years old or older;
2. onset of septic shock within 6 h

Exclusion Criteria:

1. Systemic corticosteroid therapy within the last 3 months before septic shock;
2. high-dose steroid therapy;
3. immunosuppression;
4. refusal of the attending staff or patient family.
D: Inclusion Criteria:

* Severe sepsis according to ACCP/CCM criteria
* Onset of severe sepsis \< 48 hours
* Informed consent
* Effective contraception in fertile women

Exclusion Criteria:

* Septic shock
* Known hypersensitivity to hydrocortisone and additives
* Glucocorticoid history which warrants continuation of glucocorticoid administration
* Other indication for systemic glucocorticoid therapy
* DNR-order
* Moribund patient
* Pregnancy
* Breast feeding women
* Age \< 18 years
* Other interventional study
* Relationship to investigator

Answer: B