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Patterns of endocrine secretion during sepsis.
R Dennhardt1, H J Gramm, K Meinhold
1Klinik für Anästhesiologie, Krankenhaus Nordwest, Frankfurt.
Progress in Clinical and Biological Research
|January 1, 1989
Summary
Sepsis significantly alters thyroid hormone levels, with elevated reverse triiodothyronine (rT3) and diiodotyrosine (DIT) indicating severe infection. Prolactin, catecholamines, and vasopressin also show distinct changes in septic patients.
Area of Science:
- Endocrinology
- Infectious Diseases
- Critical Care Medicine
Background:
- Sepsis presents complex endocrine dysregulation.
- Thyroid hormone abnormalities are common in critical illness.
- Specific hormonal patterns in sepsis require further elucidation.
Purpose of the Study:
- To characterize the endocrine profile of septic patients.
- To investigate the role of thyroid hormones, prolactin, catecholamines, vasopressin, and cortisol in sepsis.
- To differentiate sepsis-specific hormonal changes from general critical illness responses.
Main Methods:
- Analysis of serum concentrations of DIT, rT3, T3, prolactin, catecholamines, vasopressin, and cortisol in septic patients.
- Assessment of hormonal patterns and their correlation with disease severity.
- Evaluation of the circadian rhythm of cortisol secretion.
Main Results:
- Septic patients exhibit high DIT and rT3 serum concentrations, alongside a low T3 syndrome.
- Elevated DIT levels are particularly indicative of severe infection.
- Prolactin is consistently elevated, while catecholamines and vasopressin act as acute responders. Cortisol secretion is often elevated and its circadian rhythm is disturbed.
Conclusions:
- Sepsis induces a distinct endocrine signature characterized by specific thyroid hormone alterations and elevated prolactin.
- Hormonal responses like catecholamine and vasopressin changes are rapid.
- Cortisol secretion patterns in sepsis are variable but often show elevation and loss of normal rhythm.