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Related Concept Videos

Classification of Illness01:17

Classification of Illness

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Systemic illness.

Marta Bondanelli1, Maria Chiara Zatelli, Maria Rosaria Ambrosio

  • 1Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Ferrara, Italy.

Pituitary
|April 12, 2008
PubMed
Summary
This summary is machine-generated.

Systemic illnesses alter hormone axes, impacting pituitary gland function. Evaluating these hormonal changes is crucial for critically ill patients, though consensus on assessment criteria is lacking.

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Area of Science:

  • Endocrinology
  • Critical Care Medicine
  • Neuroendocrinology

Background:

  • Systemic illnesses trigger adaptive responses involving hypothalamic-pituitary-peripheral hormone axes.
  • The pituitary gland exhibits distinct secretory patterns (increased ACTH, PRL, GH; decreased or unchanged LH, FSH, TSH) in acute stress.
  • Protracted critical illness uniformly reduces pulsatile secretion of multiple pituitary hormones, affecting target organ function.

Purpose of the Study:

  • To critically review the evaluation of pituitary axis function in critically ill patients.
  • To discuss the adaptive hormonal changes during systemic illness.
  • To highlight the lack of consensus on assessing pituitary function in critical care.

Main Methods:

  • Literature review of hormonal axis alterations in systemic and critical illnesses.
  • Analysis of pituitary secretory patterns in acute and protracted critical illness.
  • Discussion of the implications of hormonal changes on patient outcomes.

Main Results:

  • Acute stress increases ACTH, PRL, GH and may decrease LH, FSH, TSH.
  • Critical illness leads to reduced pulsatile secretion of ACTH, TSH, LH, PRL, and GH.
  • These hormonal adaptations, if imbalanced, can increase morbidity and mortality.

Conclusions:

  • Pituitary axis dysfunction is a significant factor in critically ill patients.
  • Current criteria for evaluating pituitary axis function in critical illness lack consensus.
  • A standardized critical approach to pituitary axis evaluation is needed for better patient management.