The Endocrine System in Sepsis

  • Nicholas Heming
  • Sivanthiny Sivanandamoorthy
  • Paris Meng
  • Djillali Annane


  • The endocrine system ensures, through a closely regulated network, that body functions are properly coordinated.

  • The endocrine system is comprised of endocrine glands and their messengers.

  • The chemical mediators synthesized and secreted into the bloodstream are called hormones.

  • The acute stress response consists in producing cortisol, catecholamines, vasopressin, glucagon, and GH aimed at maintaining tissue oxygenation as well as a readily available supply of nutrients.

  • Prolonged critical illness is associated with low T3 syndrome, critical illness-related corticosteroid insufficiency, as well as reduced production of growth hormone and of gonadotropins.

  • Low T3 syndrome is probably an adaptive condition, aimed at reducing energy expenditure.

  • In conditions at risk of critical illness-related corticosteroid insufficiency such as sepsis, treatment with corticosteroids (equivalent of 200 mg hydrocortisone per day for 4 days or more) may be considered.


Stress response Cortisol Corticosteroid Septic shock Adrenal Hypothalamus Pituitary Low T3 syndrome 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nicholas Heming
    • 1
    • 2
    • 3
  • Sivanthiny Sivanandamoorthy
    • 1
    • 2
    • 3
  • Paris Meng
    • 1
    • 2
    • 3
  • Djillali Annane
    • 1
    • 2
    • 3
  1. 1.General Intensive Care UnitRaymond Poincaré HospitalGarchesFrance
  2. 2.School of Medicine Simone VeilUniversity of VersaillesVersaillesFrance
  3. 3.University Paris SaclayVersaillesFrance

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