Abstract
PURPOSE: Serum total cortisol level has been used for the diagnosis of adrenal insufficiency. However, more than 90% of circulating cortisol is protein-bound and this can affect the assessment of adrenal gland reserve in cardiac surgery patients, because the binding protein levels fall substantially during the postoperative acute phase response. To evaluate cortisol levels and their relationship to albumin levels in the context of severe stress and the acute phase response in patients undergoing cardiac surgery and to assess if the cortisol/albumin (C/A) ratio can be used to predict the need for vasopressors postoperatively.
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