The Repetitive Short Corticotropin Stimulation Test in Patients with Septic Shock
Authors: Gilles Bouachour
Journal: Annals of Internal Medicine (1995)

Letters15 December 1995The Repetitive Short Corticotropin Stimulation Test in Patients with Septic ShockGilles Bouachour, MD, Pierre-Marie Roy, MD, and Marie-Pierre Guiraud, MDGilles Bouachour, MDCentre Hospitalier Universitaire Angers 49033, France, Pierre-Marie Roy, MDCentre Hospitalier Universitaire Angers 49033, France, and Marie-Pierre Guiraud, MDCentre Hospitalier Universitaire Angers 49033, FranceAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-12-199512150-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The short corticotropin stimulation test is widely used to assess adrenocortical function in critically ill patients [1-4]. Previous studies reported that an impaired response to corticotropin was associated with poor outcome and justified hydrocortisone therapy to reduce mortality in patients with severe sepsis [1, 2]. Because patients with septic shock have widely varying cortisol levels and disruption of pulsatile cortisol secretion [5], the interpretation of the result of a short corticotropin stimulation test can be questionable.We prospectively did two consecutive short corticotropin stimulation tests in 22 patients with septic shock. Patients met the following criteria: positive ...References1. Rothwell PM, Udwadia ZF, Lawler PG. Cortisol response to corticotropin and survival in septic shock. Lancet. 1983;337:582-3. CrossrefGoogle Scholar2. McKee JI, Finlay WE. Cortisol replacement in severely stressed patients. Lancet. 1983;1:484. CrossrefMedlineGoogle Scholar3. Jurney TH, Cockrell JL, Lindberg JS, Lamiell JM, Wade CE. Spectrum of serum cortisol response to ACTH in ICU patients. Correlation with degree of illness and mortality. Chest. 1987;92:292-5. CrossrefMedlineGoogle Scholar4. Moran JL, Chapman MJ, O'Fathartaigh MS, Peisach AR, Pannall PR, Leppard P. Hypocortisolaemia and adrenocortical responsiveness at onset of septic shock. Intensive Care Med. 1994;20:489-95. CrossrefMedlineGoogle Scholar5. Voerman HJ, Strack van Schijndel RJ, Groeneveld AB, de Boer H, Nauta JP, Thijs LG. Pulsatile hormone secretion during severe sepsis: accuracy of different blood sampling regimens. Metabolism. 1992;41:934-40. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Gilles Bouachour, MD; Pierre-Marie Roy, MD; Marie-Pierre Guiraud, MDAffiliations: Centre Hospitalier Universitaire Angers 49033, France PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEditorial to: Adrenocortical function during prolonged critical illness and beyond: a prospective observational studyMonitoring of Serum Total Cortisol Level in Burned Traumatic PatientsControversies in Corticosteroid use for SepsisLongitudinal Assessment of Adrenal Function in the Early and Prolonged Phases of Critical Illness in Septic Patients: Relations to Cytokine Levels and OutcomeThe Corticotrophin Test in Critical Illness: Traps and TricksPrognostic Significance of Different Subgroup Classifications of Critical Illness-Related Corticosteroid Insufficiency in Patients With Septic ShockAssessment of the hypothalamic–pituitary–adrenal axis in critical illnessDefining critical illness-related corticosteroid insufficiency: One step forward!*Etomidate versus ketamine for sedation in acutely ill patientsPredisposing Factors for Adrenal InsufficiencyThe effects of steroids during sepsis depend on dose and severity of illness: an updated meta-analysisKortikosteroidinsuffizienz bei kritisch KrankenDiagnosis and Management of Critical Illness—Related Corticosteroid InsufficiencySystemic illnessRecommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients: Consensus statements from an international task force by the American College of Critical Care MedicineAdrenal exhaustion in septic patients with vasopressor dependencyAdrenal Insufficiency in Critical IllnessAn Update on the Diagnosis of Adrenal Insufficiency and the Use of Corticotherapy in Critical IllnessHypothalamic Pituitary Adrenal Function during Critical Illness: Limitations of Current Assessment MethodsIn the LiteratureA Single Adrenocorticotropic Hormone Stimulation Test Does Not Reveal Adrenal Insufficiency in Septic ShockRole of Corticosteroids in Septic ShockDiagnosis of Adrenal InsufficiencyRichard I. Dorin, MD, Clifford R. Qualls, PhD, and Lawrence M. Crapo, MD, PhDBaseline Cortisol Levels, Cortisol Response to Corticotropin, and Prognosis in Late Septic ShockTreatment of impaired perfusion in septic shockAdrenal insufficiency in critically illAdrenal insufficiency in septic shockUse of Corticosteroids in the Severely Ill PatientAdrenocortical function in critically ill patients 24 h after a single dose of etomidateCorticosteroids in septic shockReversal of late septic shock with supraphysiologic doses of hydrocortisoneA comparison of the adrenocortical response during septic shock and after complete recovery 15 December 1995Volume 123, Issue 12 Page: 962-963 Keywords Adrenocorticotropic hormone Blood pressure Cortisol Mortality Patients Resuscitation Sepsis Shock Systolic pressure Vasopressors ePublished: 15 August 2000 Issue Published: 15 December 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...