Abstract
There has been a lot of debate about the concept of relative adrenocortical insufficiency (often defined as a reduced response to corticotropin) as a pathophysiological explanation of steroid effects in septic shock. Less is known about the prevalence of absolute adrenocortical insufficiency based on more usual definitions (low baseline and corticotropin stimulated cortisol). A study by Wu and colleagues provides convincing evidence that critically ill patients could evolve from a normal adrenal status towards very low cortisol levels within a few days. Although the exact consequences of these findings deserve more investigation, adrenal testing should not be omitted in patients not improving their hemodynamic status.
Highlights
In the previous issue of Critical Care, Wu and colleagues [1] report delayed adrenal insufficiency in 15 critically ill patients on the basis of a repeated plasma cortisol test among a prospective cohort of 53 patients who had normal or high cortisol levels on first testing and did not exhibit clinical improvement with treatment
The authors must be congratulated for these findings, which add a new piece in the complex puzzle of adrenocortical function, steroid treatment and outcome in the intensive care unit (ICU)
Most investigators would agree that its usual definition is an absolute cortisol increase
Summary
In the previous issue of Critical Care, Wu and colleagues [1] report delayed adrenal insufficiency in 15 critically ill patients on the basis of a repeated plasma cortisol test among a prospective cohort of 53 patients who had normal or high cortisol levels on first testing and did not exhibit clinical improvement with treatment. The authors must be congratulated for these findings, which add a new piece in the complex puzzle of adrenocortical function, steroid treatment and outcome in the intensive care unit (ICU).
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
