Eva Boonen, Lies Langouche, Thomas Janssens, Philippe Meersseman, Hilke Vervenne, Emilie De Samblanx, Zoƫ Pironet, Lisa Van Dyck, Sarah Vander Perre, Inge Derese, Greet Van den Berghe
CONTEXT: Adrenal insufficiency is considered to be prevalent during critical illness, although the pathophysiology, diagnostic criteria, and optimal therapeutic strategy remain controversial. During critical illness, reduced cortisol breakdown contributes substantially to elevated plasma cortisol and low plasma ACTH concentrations. OBJECTIVE: Because ACTH has a trophic impact on the adrenal cortex, we hypothesized that with a longer duration of critical illness, subnormal ACTH adrenocortical stimulation predisposes to adrenal insufficiency...
November 2014: Journal of Clinical Endocrinology and Metabolism