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Plasma cortisol levels in patients with septic shock
R M Schein1, C L Sprung, E Marcial
1Department of Medicine, Veterans Administration Medical Center, Miami, FL 33125.
Critical Care Medicine
|March 1, 1990
Summary
Patients with septic shock exhibit elevated plasma cortisol levels, indicating an adrenocortical response. Cortisol levels varied, potentially influenced by infection type and shock duration.
Area of Science:
- Endocrinology
- Critical Care Medicine
- Infectious Diseases
Background:
- Sepsis can trigger an endogenous adrenocortical response.
- Understanding cortisol levels in septic shock is crucial for patient management.
Purpose of the Study:
- To investigate plasma cortisol concentrations in patients experiencing septic shock.
- To explore factors influencing cortisol levels during septic shock.
Main Methods:
- Measured plasma cortisol in 37 septic shock patients.
- Analyzed correlations with infection type, vasopressor use, shock severity, and duration.
Main Results:
- Septic shock patients showed significantly increased plasma cortisol levels (median 50.7 µg/dL).
- Gram-positive infections were associated with higher cortisol than Gram-negative infections.
- Cortisol levels showed weak negative correlations with time in shock and mean arterial pressure.
Conclusions:
- Plasma cortisol is elevated in septic shock, with considerable variability.
- Infection type, shock duration, and blood pressure may influence cortisol levels.