Abstract
Several recent studies have given rise to optimism concerning steroid treatment in septic shock. ‘Physiological’ doses of steroids have been shown to reduce time to shock reversal and may even be able to decrease mortality [1–3]. Assuming that forthcoming studies will confirm these results, steroid treatment will go through a revival [4]. The term: ‘relative adrenal insufficiency syndrome’ has already become established and — as mortality from severe sepsis is still more than 40% despite advances in critical care — expectations for therapeutic consequences are high.
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References
Briegel J, Forst H, Haller M, Schelling G, et al (1999) Stress doses of hydrocortisone reverse hyperdynamic septic shock: a prospective, randomized, double-blind, single-center study. Crit Care Med 27: 723–732
Bollaert PE, Charpentier C, Levy B, Debouverie M, Audibert G, Larcan A (1998) Reversal of late septic shock with supraphysiologic doses of hydrocortisone. Crit Care Med. 26: 645–650
Chawla K, Kupfer Y, Goldman I, Tessler S (1999) Hydrocortisone reverses refractory septic shock. Crit Care Med 27: A33
Spijkstra JJ, Girbes AR (2000) The continuing story of corticosteroids in the treatment of septic shock. Intensive Care Med 26: 496–500
Bollaert PE (2000) Stress doses of glucocorticoids in catecholamine dependency: a new therapy for a new syndrome? Intensive Care Med 26: 3–5
Annane D, Sebille V, Troche G, Raphael JC, Gajdos P, Bellissant E (2000) A 3-level prognostic classification in septic shock based on cortisol levels and cortisol response to corticotropin. JAMA 283: 1038–1045
Bouachour G, Tirot P, Gouello JP, Mathieu E, Vincent JF, Alquier P (1995) Adrenocortical function during septic shock. Intensive Care Med 21: 57–62
Braams R, Koppeschaar HP, van de Pavoordt HD, van Vroonhoven TJ (1998) Adrenocortical function in patients with ruptured aneurysm of the abdominal aorta. Intensive Care Med 24: 124–127
Briegel J, Schelling G, Haller M, Mraz W, Forst H, Peter K (1996) A comparison of the adrenocortical response during septic shock and after complete recovery. Intensive Care Med 22: 894–899
Jurney TH, Cockrell JL Jr., Lindberg JS, Lamiell JM, Wade CE (1987) Spectrum of serum cortisol response to ACTH in ICU patients. Correlation with degree of illness and mortality. Chest 92: 292–295
Span LF, Hermus AR, Bartelink AK, et al (1992) Adrenocortical function: an indicator of severity of disease and survival in chronic critically ill patients. Intensive Care Med 18: 93–96
Rothwell PM, Udwadia ZF, Lawler PG (1991) Cortisol response to corticotropin and survival in septic shock. Lancet 337: 582–583
Ligtenberg JJM, Pieters RC, Nijsten MWN, Delwig H (2001) No correlation between serum calcium and serum cortisol in critically ill patients. Am J Respir Crit Care Med 163: D41
Beishuizen A, Vermes I, Hylkema BS, Haanen C (1999) Relative eosinophilia and functional adrenal insufficiency in critically ill patients. Lancet 353: 1675–1676
Oppert M, Reinicke A, Graf KJ, Barckow D, Frei U, Eckardt KU (1999) Plasma cortisol levels before and during low-dose’ hydrocortison therapy and their relationship to hemodynamic improvement in patients with septic shock. Intensive Care Med 26: 1747–1755
Lamberts SW, Bruining HA, de Jong FH (1997) Corticosteroid therapy in severe illness. N Engl J Med 337: 1285–1292
Van den Berghe, de Zegher F, Veldhuis JD, et al (1997) Thyrotrophin and prolactin release in prolonged critical illness: dynamics of spontaneous secretion and effects of growth hormonesecretagogues. Clin Endocrinol 47: 599–612
Barquist E, Kirton O (1997) Adrenal insufficiency in the surgical intensive care unit patient. J Trauma 42: 27–31
Ligtenberg JJM, Nieboer P, Beentjes JA, van der Werf TS, Tulleken JE, Zijlstra JG (2000) A new therapy for a new syndrome. Intensive Care Med 26: 1013–1014
Bos Kuil MJ, Endert E, Fliers E, Prummel MF, Romijn JA, Wiersinga WM (1998) Establishment of reference values for endocrine tests. I: Cushing’s syndrome. Neth J Med 53: 153–163
Dickstein G, Shechner C, Nicholson WE, et al (1991) Adrenocorticotropin stimulation test: effects of basal cortisol level, time of day, and suggested new sensitive low dose test. J Clin Endocrinol Metab 72: 773–778
Streeten DH (1999) What test for hypothalamic-pituitary-adrenocortical insufficiency? Lancet 354: 179–180
Reincke M, Allolio B, Wurth G, Winkelmann W (1993) The hypothalamic-pituitary-adrenal axis in critical illness: response to dexamethasone and corticotropin-releasing hormone. J Clin Endocrinol Metab 77: 151–156
Ligtenberg JJM, Zijlstra JG, Girbes AR (2000) Noradrenaline in meningococcal septic shock. Intensive Care Med 26: 1588–1589
Ligtenberg JJM, Girbes AR, Beentjes JA, Tulleken JE, Der Werf TS, Zijlstra JG (2001) Hormones in the critically ill patient: to intervene or not to intervene? Intensive Care Med 27: 1567–1577
Thorn GW, Forsham PH, Prunty FTG, Hills AG (2001) A test for adrenal cortical insufficiency. JAMA 137: 1005–1009
DiPiro JT, Howdieshell TR, Hamilton RG, Mansberger AR Jr (1998) Immunoglobulin E and eosinophil counts are increased after sepsis in trauma patients. Crit Care Med 26: 465–469
Beishuizen A, Vermes I (1999) Relative eosinophilia ( Thorn test) as a bioassay to judge the clinical relevance of cortisol values during severe stress. J Clin Endocrinol Metab 84: 3400
Ligtenberg JJ, van der Werf TS, Tulleken JE, Beentjes JA, Zijlstra JG (1999) Diagnosis of relative adrenal insufficiency in critically ill patients. Lancet 354: 774–775
Van den Berghe, de Zegher F, Baxter RC et al (1998) Neuroendocrinology of prolonged critical illness: effects of exogenous thyrotropin-releasing hormone and its combination with growth hormone secretagogues. J Clin Endocrinol Metab 83: 309–319
Annane D (2001) Corticosteroids for septic shock. Crit Care Med 29: S117 - S120
Saito T, Takanashi M, Gallagher E, et al (1995) Corticosteroid effect on early beta-adrenergic down-regulation during circulatory shock: hemodynamic study and beta-adrenergic receptor assay. Intensive Care Med 21: 204–210
Walker BR, Williams BC (1992) Corticosteroids and vascular tone: mapping the messenger maze. Clin Sci (Colch) 82: 597–605
Bone RC, Grodzin CJ, Balk RA (1997) Sepsis: a new hypothesis for pathogenesis of the disease process. Chest 112: 235–243
Meduri GU, Headley AS, Golden E, et al (1998) Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial. JAMA 280: 159–165
Kam JC, Szefler SJ, Surs W, Sher ER, Leung DY (1993) Combination IL-2 and IL-4 reduces glucocorticoid receptor-binding affinity and T cell response to glucocorticoids. J Immunol 151: 3460–3466
Williams GH, Dluhy RG (1998) Endocrinology and metabolism. In: Fauci AS, Braunswald E, Isselbacher KJ (eds) Harrison’s Principles of Internal Medicine (Single Volume). McGraw Hill, New York, pp 2040–2041
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Ligtenberg, J.J.M., Zijlstra, J.G. (2002). Relative Adrenal Insufficiency Syndrome. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-5551-0_45
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DOI: https://doi.org/10.1007/978-1-4757-5551-0_45
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