Adrenal insufficiency in critically ill septic patients at Dr George Mukhari Hospital

Abstract

AbstractRationale: Adrenal insufficiency occurs with varying frequency in critically ill patients. It is usually associated with a high mortality and poor clinical outcome. Objective: To determine the incidence of adrenal failure in patients with severe sepsis and septic shock admitted to our intensive care unit. Design: Prospective observational study, over a two year period (June 2003—June 2005). Setting: University hospital multi-disciplinary intensive care unit in South Africa. Patients: One hundred and fifty-two patients with severe sepsis and septic shock. Patients with a history of adrenal insufficiency, those on steroid therapy and all those who received etomidate within a week prior to enrollment were excluded. Interventions: None. Measurements and main results: A random plasma cortisol level was measured in consecutive patients with severe sepsis and septic shock. Adrenal insufficiency was defined as a cortisol level below 20μg/dL. The incidence of adrenal insufficiency was 26, 97% (CI: 19, 97%–...