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Journal of Intensive Care Medicine
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Adrenal Insufficiency in Critical Illness

Mark Stuart Cooper, BM BCh, MRCP, PhD

Department of Endocrinology, Division of Medical Sciences, Institute of Biomedical Research, The University of Birmingham, United Kingdom, m.s.cooper@ bham.ac.uk

Paul Michael Stewart, MD, FRCP, FmedSci

Department of Endocrinology, Division of Medical Sciences, Institute of Biomedical Research, The University of Birmingham, United Kingdom

One of the more controversial areas in critical care in recent decades relates to the issue of adrenal insufficiency and its treatment in critically ill patients. There is no consensus on which patients to test for adrenal insufficiency, which tests to use and how to interpret them, whether to use corticosteroids, and, if so, who to treat and with what dose. This review illustrates the complexity and diversity of pathophysiological changes in glucocorticoid secretion, metabolism, and action and how these are affected by various types of illness. It will review adrenal function testing and give guidance on corticosteroid replacement regimens based on current published literature. There remain inherent difficulties in interpreting the effects of glucocorticoid replacement during critical illness because of the diversity of effects of glucocorticoids on various tissues. Investigation and treatment will depend on whether the likely cause of corticosteroid insufficiency is adrenal or central in origin.

Key Words: corticosteroids • hydrocortisone • cortisol • sepsis • adrenal insu ficiency • Addison's disease

References

  • Annane D. Glucocorticoids in the treatment of severe sepsis and septic shock. Curr Opin Crit Care. 2005;11:449-453.[CrossRef][Medline] [Order article via Infotrieve]
  • Cooper MS, Stewart PM Corticosteroid insufficiency in acutely ill patients. N Engl J Med. 2003;348:727-734.[Free Full Text]
  • Arafah BM Hypothalamic pituitary adrenal function during critical illness: limitations of current assessment methods. J Clin Endocrinol Metab. 2006;91:3725-3745.[Abstract/Free Full Text]
  • Jacobi J. Corticosteroid replacement in critically ill patients. Crit Care Clin. 2006;22:245-253, vi.[CrossRef][Medline] [Order article via Infotrieve]
  • Marik PE, Zaloga GP Adrenal insufficiency in the critically ill: a new look at an old problem. Chest. 2002;122:1784-1796.[Abstract/Free Full Text]
  • White PC, Mune T., Agarwal.AK 11ß-Hydroxysteroid dehydrogenase and the syndrome of apparent mineralocorticoid excess. Endocr Rev. 1997;18:135-156.[Abstract/Free Full Text]
  • Stewart PM, Walker BR, Holder G., O'Halloran D., Shackleton CH 11ß-Hydroxysteroid dehydrogenase activity in Cushing's syndrome: explaining the mineralocorticoid excess state of the ectopic adrenocorticotropin syndrome. J Clin Endocrinol Metab. 1995;80:3617-3620.[Abstract]
  • Labrie F., Luu-The V., Labrie C., et al. Endocrine and intracrine sources of androgens in women: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Endocr Rev. 2003;24:152-182.[Abstract/Free Full Text]
  • Parker LN, Levin ER, Lifrak ET Evidence for adrenocortical adaptation to severe illness. J Clin Endocrinol Metab. 1985;60:947-952.[Abstract/Free Full Text]
  • Rosner W. The functions of corticosteroid-binding globulin and sex hormone-binding globulin: recent advances. Endocr Rev. 1990;11:80-91.[Abstract/Free Full Text]
  • Hamrahian AH, Oseni TS, Arafah BM Measurements of serum free cortisol in critically ill patients. N Engl J Med. 2004;350:1629-1638.[Abstract/Free Full Text]
  • Torpy DJ, Bachmann AW, Grice JE, et al. Familial corticosteroid-binding globulin deficiency due to a novel null mutation: association with fatigue and relative hypotension. J Clin Endocrinol Metab. 2001;86:3692-3700.[Abstract/Free Full Text]
  • Ho JT, Al Musalhi H., Chapman MJ, et al. Septic shock and sepsis: a comparison of total and free plasma cortisol levels. J Clin Endocrinol Metab. 2006;91:105-114.[Abstract/Free Full Text]
  • Morita H., Isomura Y., Mune T., et al. Plasma cortisol and cortisone concentrations in normal subjects and patients with adrenocortical disorders. Metabolism. 2004;53:89-94.[CrossRef][Medline] [Order article via Infotrieve]
  • Tomlinson JW, Walker EA, Bujalska IJ, et al. 11ß-hydroxysteroid dehydrogenase type 1: a tissue-specific regulator of glucocorticoid response. Endocr Rev. 2004;25:831-866.[Abstract/Free Full Text]
  • Escher G., Galli I., Vishwanath BS, Frey BM, Frey FJ Tumor necrosis factor-{alpha} and interleukin-1ß enhance the cortisone/ cortisol shuttle. J Exp Med. 1997;186:189-198.[Abstract/Free Full Text]
  • Cooper MS, Bujalska I., Rabbitt E., et al. Modulation of 11ß-hydroxysteroid dehydrogenase isozymes by proinflammatory cytokines in osteoblasts: an autocrine switch from glucocorticoid inactivation to activation. J Bone Miner Res. 2001;16:1037-1044.[CrossRef][Medline] [Order article via Infotrieve]
  • Gilmour JS, Coutinho AE, Cailhier JF, et al. Local amplification of glucocorticoids by 11 beta-hydroxysteroid dehydrogenase type 1 promotes macrophage phagocytosis of apoptotic leukocytes. J Immunol. 2006;176:7605-7611.[Abstract/Free Full Text]
  • Van den Berghe G., de Zegher F., Bouillon R. Clinical review 95: acute and prolonged critical illness as different neuroendocrine paradigms. J Clin Endocrinol Metab. 1998;83:1827-1834.[Free Full Text]
  • Vanhorebeek I., Van den Berghe G. The neuroendocrine response to critical illness is a dynamic process. Crit Care Clin. 2006; 22:1-15, v.[CrossRef][Medline] [Order article via Infotrieve]
  • Offner PJ, Moore EE, Ciesla D. The adrenal response after severe trauma. Am J Surg, 2002;184:649-653.[CrossRef][Medline] [Order article via Infotrieve]
  • Skillman JJ, Lauler DP, Hickler RB, et al. Hemorrhage in normal man: effect on renin, cortisol, aldosterone, and urine composition. Ann Surg, 1967;166:865-885.[Medline] [Order article via Infotrieve]
  • Rivers EP, Gaspari M., Saad GA, et al. Adrenal insufficiency in high-risk surgical ICU patients. Chest, 2001;119:889-896.[Abstract/Free Full Text]
  • Pene F., Hyvernat H., Mallet V., et al. Prognostic value of relative adrenal insufficiency after out-of-hospital cardiac arrest. Intensive Care Med, 2005;31:627-633.[CrossRef][Medline] [Order article via Infotrieve]
  • Rushing GD, Britt RC, Collins JN, et al. Adrenal insufficiency in hemorrhagic shock. Am Surg. 2006;72:552-554.[Medline] [Order article via Infotrieve]
  • Hoen S., Asehnoune K., Brailly-Tabard S., et al. Cortisol response to corticotropin stimulation in trauma patients: influence of hemorrhagic shock. Anesthesiology. 2002;97:807-813.[CrossRef][Medline] [Order article via Infotrieve]
  • Schroeder S., Wichers M., Klingmuller D., et al. The hypothalamic-pituitary-adrenal axis of patients with severe sepsis: altered response to corticotropin-releasing hormone. Crit Care Med. 2001;29:310-316.[CrossRef][Medline] [Order article via Infotrieve]
  • Melby JC, Spink WW Comparative studies on adrenal cortical function and cortisol metabolism in healthy adults and in patients with shock due to infection. J Clin Invest. 1958; 37:1791-1798.[Medline] [Order article via Infotrieve]
  • Briegel J., Schelling G., Haller M., et al. A comparison of the adrenocortical response during septic shock and after complete recovery. Intensive Care Med. 1996;22:894-899.[Medline] [Order article via Infotrieve]
  • Yildiz O., Doganay M., Aygen B., et al. Physiological-dose steroid therapy in sepsis [ISRCTN36253388]. Crit Care. 2002;6:251-259.[CrossRef][Medline] [Order article via Infotrieve]
  • Annane D., Sebille V., Troche G., et al. A 3-level prognostic classification in septic shock based on cortisol levels and cortisol response to corticotropin. JAMA. 2000;283:1038-1045.[Abstract/Free Full Text]
  • Sibbald WJ, Short A., Cohen MP, Wilson RF Variations in adrenocortical responsiveness during severe bacterial infections: unrecognized adrenocortical insufficiency in severe bacterial infections. Ann Surg. 1977;186:29-33.[Medline] [Order article via Infotrieve]
  • Sam S., Corbridge TC, Mokhlesi B., Comellas AP, Molitch ME Cortisol levels and mortality in severe sepsis. Clin Endocrinol (Oxf). 2004;60:29-35.[CrossRef][Medline] [Order article via Infotrieve]
  • Esteban NV, Loughlin T., Yergey AL, et al. Daily cortisol production rate in man determined by stable isotope dilution/ mass spectrometry. J Clin Endocrinol Metab. 1991;72:39-45.[Abstract/Free Full Text]
  • Purnell JQ, Brandon DD, Isabelle LM, Loriaux DL, Samuels MH Association of 24-hour cortisol production rates, cortisol-binding globulin, and plasma-free cortisol levels with body composition, leptin levels, and aging in adult men and women. J Clin Endocrinol Metab. 2004;89:281-287.[Abstract/Free Full Text]
  • Yildiz O., Doganay M., Aygen B., et al. Physiological-dose steroid therapy in sepsis [ISRCTN36253388]. Crit Care. 2002; 6:251-259.[CrossRef][Medline] [Order article via Infotrieve]
  • Bornstein SR, Chrousos GP Clinical review 104: adrenocorticotropin (ACTH)- and non-ACTH-mediated regulation of the adrenal cortex: neural and immune inputs. J Clin Endocrinol Metab. 1999;84:1729-1736.[Free Full Text]
  • Perrot D., Bonneton A., Dechaud H., Motin J., Pugeat M. Hypercortisolism in septic shock is not suppressible by dexamethasone infusion. Crit Care Med. 1993;21:396-401.[Medline] [Order article via Infotrieve]
  • Vanhorebeek I., Peeters, RP, Vander PS, et al. Cortisol response to critical illness: effect of intensive insulin therapy. J Clin Endocrinol Metab. 2006;91:3803-3813.[Abstract/Free Full Text]
  • Vogeser M., Groetzner J., Kupper C., Briegel J. The serum cortisol:cortisone ratio in the postoperative acute-phase response. Horm Res. 2003;59:293-296.[CrossRef][Medline] [Order article via Infotrieve]
  • Hardy RS, Filer A., Cooper MS, et al. Differential expression, function and response to inflammatory stimuli of 11 beta-hydroxysteroid dehydrogenase type 1 in human fibroblasts: a mechanism for tissue-specific regulation of inflammation. Arthritis Res Ther. 2006;8:R108.[CrossRef][Medline] [Order article via Infotrieve]
  • Loisa P., Rinne T., Kaukinen S. Adrenocortical function and multiple organ failure in severe sepsis. Acta Anaesthesiol Scand. 2002;46:145-151.[CrossRef][Medline] [Order article via Infotrieve]
  • Beishuizen A., Thijs LG, Vermes I. Patterns of corticosteroid-binding globulin and the free cortisol index during septic shock and multitrauma. Intensive Care Med. 2001;27: 1584-1591.[CrossRef][Medline] [Order article via Infotrieve]
  • Hammond GL, Smith CL, Paterson NA, Sibbald WJ A role for corticosteroid-binding globulin in delivery of cortisol to activated neutrophils. J Clin Endocrinol Metab. 1990;71:34-39.[Abstract/Free Full Text]
  • Aimaretti G., Ambrosio MR, Di Somma C., et al. Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism: screening study at 3 months after the brain injury. Clin Endocrinol (Oxf). 2004;61:320-326.[CrossRef][Medline] [Order article via Infotrieve]
  • Kreitschmann-Andermahr I., Hoff C., Saller B., et al. Prevalence of pituitary deficiency in patients after aneurysmal subarachnoid hemorrhage. J Clin Endocrinol Metab. 2004;89:4986-4992.[Abstract/Free Full Text]
  • Arvat E., Giordano R., Grottoli S., Ghigo E. Benzodiazepines and anterior pituitary function. J Endocrinol Invest. 2002; 25:735-747.[Medline] [Order article via Infotrieve]
  • Waterhouse R. A case of suprarenal apoplexy. Lancet. 1911; I:577-578.
  • Adem PV, Montgomery CP, Husain AN, et al. Staphylococcus aureus sepsis and the Waterhouse-Friderichsen syndrome in children. N Engl J Med. 2005;353:1245-1251.[Abstract/Free Full Text]
  • Seidenwurm DJ, Elmer EB, Kaplan LM, et al. Metastases to the adrenal glands and the development of Addison's disease. Cancer. 1984;54:552-557.[CrossRef][Medline] [Order article via Infotrieve]
  • Judd AM, Call GB, Barney M., et al. Possible function of IL-6 and TNF as intraadrenal factors in the regulation of adrenal steroid secretion. Ann N Y Acad Sci. 2000;917:628-637.[Medline] [Order article via Infotrieve]
  • Subramanian S., Goker H., Kanji A., Sweeney H. Clinical adrenal insufficiency in patients receiving megestrol therapy. Arch Intern Med. 1997;157:1008-1011.[Abstract/Free Full Text]
  • Malik KJ, Wakelin K., Dean S., Cove DH, Wood PJ Cushing's syndrome and hypothalamic-pituitary adrenal axis suppression induced by medroxyprogesterone acetate. Ann Clin Biochem. 1996;33:187-189.[Medline] [Order article via Infotrieve]
  • Greenfield JR, Samaras K. Suppression of HPA axis in adults taking inhaled corticosteroids. Thorax. 2006;61:272-273.[Free Full Text]
  • Jackson WL Jr. Should we use etomidate as an induction agent for endotracheal intubation in patients with septic shock? A critical appraisal. Chest 2005;127:1031-1038.[Abstract/Free Full Text]
  • Watt I., Ledingham IM Mortality amongst multiple trauma patients admitted to an intensive therapy unit. Anaesthesia. 1984;39:973-981.[Medline] [Order article via Infotrieve]
  • Allolio B., Stuttmann R., Fischer H., Leonhard W., Winkelmann W. Long-term etomidate and adrenocortical suppression. Lancet. 1983;2:626.[Medline] [Order article via Infotrieve]
  • Wagner RL, White PF, Kan PB, Rosenthal MH, Feldman D. Inhibition of adrenal steroidogenesis by the anesthetic etomidate. N Engl J Med. 1984;310:1415-1421.[Abstract]
  • den Brinker M., Joosten KF, Liem O., et al. Adrenal insufficiency in meningococcal sepsis: bioavailable cortisol levels and impact of interleukin-6 levels and intubation with etomidate on adrenal function and mortality. J Clin Endocrinol Metab. 2005;90:5110-5117.[Abstract/Free Full Text]
  • Norbiato G., Galli M., Righini V., Moroni M. The syndrome of acquired glucocorticoid resistance in HIV infection. Baillieres Clin Endocrinol Metab. 1994;8:777-787.[CrossRef][Medline] [Order article via Infotrieve]
  • Luppa P., Munker R., Nagel D., Weber M., Engelhardt D. Serum androgens in intensive-care patients: correlations with clinical findings. Clin Endocrinol (Oxf). 1991;34:305-310.[Medline] [Order article via Infotrieve]
  • Marx C., Petros S., Bornstein SR, et al. Adrenocortical hormones in survivors and nonsurvivors of severe sepsis: diverse time course of dehydroepiandrosterone, dehydroepiandrosterone-sulfate, and cortisol. Crit Care Med. 2003;31:1382-1388.[CrossRef][Medline] [Order article via Infotrieve]
  • Arlt W., Hammer F., Sanning P., et al. Dissociation of serum dehydroepiandrosterone and dehydroepiandrosterone sulfate in septic shock. J Clin Endocrinol Metab. 2006;91:548-2554.
  • Burchard K. A review of the adrenal cortex and severe inflammation: quest of the "eucorticoid" state. J Trauma. 2001;51:800-814.[Medline] [Order article via Infotrieve]
  • Nieboer P., van der Werf TS, Beentjes JA, et al. Catecholamine dependency in a polytrauma patient: relative adrenal insufficiency? Intensive Care Med. 2000;26:125-127.[CrossRef][Medline] [Order article via Infotrieve]
  • Bouachour G., Roy PM, Guiraud MP The repetitive short corticotropin stimulation test in patients with septic shock. Ann Intern Med. 1995;123:962-963.[Free Full Text]
  • Manglik S., Flores E., Lubarsky L., et al. Glucocorticoid insufficiency in patients who present to the hospital with severe sepsis: a prospective clinical trial. Crit Care Med. 2003;31: 1668-1675.[CrossRef][Medline] [Order article via Infotrieve]
  • Reichardt HM, Umland T., Bauer A., Kretz O., Schutz G. Mice with an increased glucocorticoid receptor gene dosage show enhanced resistance to stress and endotoxic shock. Mol Cell Biol. 2000;20:9009-9017.[Abstract/Free Full Text]
  • Lazar G. Jr, Lazar G., Agarwal MK Modification of septic shock in mice by the antiglucocorticoid RU 38486. Circ Shock. 1992;36:180-184.[Medline] [Order article via Infotrieve]
  • Leonard MO, Godson C., Brady HR, Taylor CT Potentiation of glucocorticoid activity in hypoxia through induction of the glucocorticoid receptor. J Immunol. 2005; 174:2250-2257.[Abstract/Free Full Text]
  • Duma D., Silva-Santos JE, Assreuy J. Inhibition of glucocorticoid receptor binding by nitric oxide in endotoxemic rats. Crit Care Med. 2004;32:2304-2310.[Medline] [Order article via Infotrieve]
  • Molijn GJ, Spek JJ, van Uffelen JC, et al. Differential adaptation of glucocorticoid sensitivity of peripheral blood mononuclear leukocytes in patients with sepsis or septic shock. J Clin Endocrinol Metab. 1995;80:1799-1803.[Abstract]
  • Beishuizen A., Vermes I., Hylkema BS, Haanen C. Relative eosinophilia and functional adrenal insufficiency in critically ill patients. Lancet. 1999;353:1675-1676.[CrossRef][Medline] [Order article via Infotrieve]
  • Saito T., Fuse A., Gallagher ET, et al. The effect of methylprednisolone on myocardial beta-adrenergic receptors and cardiovascular function in shock patients. Shock. 1996;5: 241-246.[Medline] [Order article via Infotrieve]
  • Cooper MS, Stewart PM Diagnosis and treatment of ACTH deficiency. Rev Endocr Metab Disord. 2005;6:47-54.[CrossRef][Medline] [Order article via Infotrieve]
  • Stewart PM, Corrie J., Seckl JR, Edwards CR, Padfield PL A rational approach for assessing the hypothalamo-pituitary-adrenal axis. Lancet. 1988;1:1208-1210.[CrossRef][Medline] [Order article via Infotrieve]
  • Dickstein G., Shechner C., Nicholson WE, et al. Adrenocorticotropin stimulation test: effects of basal cortisol level, time of day, and suggested new sensitive low dose test. J Clin Endocrinol Metab. 1991;72:773-778.[Abstract/Free Full Text]
  • Clark PM, Neylon I., Raggatt PR, Sheppard MC, Stewart PM Defining the normal cortisol response to the short Synacthen test: implications for the investigation of hypothalamic-pituitary disorders. Clin Endocrinol (Oxf). 1998;49:287-292.[CrossRef][Medline] [Order article via Infotrieve]
  • Erturk E., Jaffe CA, Barkan AL Evaluation of the integrity of the hypothalamic-pituitary-adrenal axis by insulin hypoglycemia test. J Clin Endocrinol Metab. 1998;83:2350-2354.[Abstract/Free Full Text]
  • Jubiz W., Meikle AW, West CD, Tyler FH Single-dose metyrapone test. Arch Intern Med. 1970;125:472-474.[Abstract/Free Full Text]
  • Cohen J., Venkatesh B., Galligan J., Thomas P. Salivary cortisol concentration in the intensive care population: correlation with plasma cortisol values. Anaesth Intensive Care. 2004; 32:843-845.[Medline] [Order article via Infotrieve]
  • Rothwell PM, Udwadia ZF, Lawler PG Cortisol response to corticotropin and survival in septic shock. Lancet. 1991;337:582-583.[CrossRef][Medline] [Order article via Infotrieve]
  • Annane D., Sebille V., Charpentier C., et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002;288:862-871.[Abstract/Free Full Text]
  • Widmer IE, Puder JJ, Konig, C., et al. Cortisol response in relation to the severity of stress and illness. J Clin Endocrinol Metab. 2005;90:4579-4586.[Abstract/Free Full Text]
  • Tsai MH, Peng YS, Chen YC, et al. Adrenal insufficiency in patients with cirrhosis, severe sepsis and septic shock. Hepatology. 2006;43:673-681.[CrossRef][Medline] [Order article via Infotrieve]
  • Siraux V., De Backer D., Yalavatti G., et al. Relative adrenal insufficiency in patients with septic shock: comparison of low-dose and conventional corticotropin tests. Crit Care Med. 2005;33:2479-2486.[CrossRef][Medline] [Order article via Infotrieve]
  • Annane D., Sebille V., Charpentier C., et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002;288:862-871.[Abstract/Free Full Text]
  • Loisa P., Uusaro A., Ruokonen E. A single adrenocorticotropic hormone stimulation test does not reveal adrenal insufficiency in septic shock. Anesth Analg. 2005;101:1792-1798.[Abstract/Free Full Text]
  • Venkatesh B., Mortimer RH, Couchman B., Hall J. Evaluation of random plasma cortisol and the low dose corticotropin test as indicators of adrenal secretory capacity in critically ill patients: a prospective study. Anaesth Intensive Care. 2005;33:201-209.[Medline] [Order article via Infotrieve]
  • Schuler JJ, Erve PR, Schumer W. Glucocorticoid effect on hepatic carbohydrate metabolism in the endotoxin-shocked monkey. Ann Surg. 1976;183:345-354.[Medline] [Order article via Infotrieve]
  • Schumer W. Steroids in the treatment of clinical septic shock. Ann Surg. 1976;184:333-341.[Medline] [Order article via Infotrieve]
  • Sprung CL, Caralis PV, Marcial EH, et al. The effects of high-dose corticosteroids in patients with septic shock: a prospective, controlled study. N Engl J Med. 1984;311:1137-1143.[Abstract]
  • Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis: the Veterans Administration Systemic Sepsis Cooperative Study Group. N Engl J Med. 1987;317:659-665.[Abstract]
  • Bone RC, Fisher CJ Jr, Clemmer TP, et al. A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med. 1987;317: 653-658.[Abstract]
  • Lefering R., Neugebauer EA Steroid controversy in sepsis and septic shock: a meta-analysis. Crit Care Med. 1995;23: 1294-1303.[CrossRef][Medline] [Order article via Infotrieve]
  • Cronin L., Cook DJ, Carlet J., et al. Corticosteroid treatment for sepsis: a critical appraisal and meta-analysis of the literature. Crit Care Med. 1995;23:1430-1439.[CrossRef][Medline] [Order article via Infotrieve]
  • Briegel J., Forst H., Haller M., et al. Stress doses of hydrocortisone reverse hyperdynamic septic shock: a prospective, randomized, double-blind, single-center study. Crit Care Med. 1999;27:723-732.[CrossRef][Medline] [Order article via Infotrieve]
  • Bollaert PE, Charpentier C., Levy B., et al. Reversal of late septic shock with supraphysiologic doses of hydrocortisone. Crit Care Med. 1998;26:645-650.[CrossRef][Medline] [Order article via Infotrieve]
  • Marik PE, Zaloga GP Adrenal insufficiency during septic shock. Crit Care Med. 2003;31:141-145.[CrossRef][Medline] [Order article via Infotrieve]
  • Markovitz BP, Goodman DM, Watson RS, Bertoch D., Zimmerman J. A retrospective cohort study of prognostic factors associated with outcome in pediatric severe sepsis: what is the role of steroids? Pediatr Crit Care Med. 2005;6:270-274.[CrossRef][Medline] [Order article via Infotrieve]
  • Rady MY, Johnson DJ, Patel B., Larson J., Helmers R. Cortisol levels and corticosteroid administration fail to predict mortality in critical illness: the confounding effects of organ dysfunction and sex. Arch Surg. 2005;140:661-668.[Abstract/Free Full Text]
  • Britt RC, Devine A., Swallen KC, et al. Corticosteroid use in the intensive care unit: at what cost? Arch Surg. 2006;141: 145-149.[Abstract/Free Full Text]
  • Rady MY, Johnson DJ, Patel B., Larson J., Helmers R. Corticosteroids influence the mortality and morbidity of acute critical illness. Crit Care. 2006;10:R101.[CrossRef][Medline] [Order article via Infotrieve]
  • Noble DW Dose effects of steroids on survival in sepsis. Ann Intern Med. 2004;141:891.[Free Full Text]
  • Annane D., Bellissant E., Bollaert PE, et al. Corticosteroids for severe sepsis and septic shock: a systematic review and meta-analysis. BMJ. 2004;329:480.[Abstract/Free Full Text]
  • Minneci PC, Deans KJ, Banks SM, Eichacker PQ, Natanson C. Meta-analysis: the effect of steroids on survival and shock during sepsis depends on the dose. Ann Intern Med. 2004; 141:47-56.[Abstract/Free Full Text]
  • Keh D., Boehnke T., Weber-Cartens S., et al. Immunologic and hemodynamic effects of "low-dose" hydrocortisone in septic shock: a double-blind, randomized, placebo-controlled, crossover study. Am J Respir Crit Care Med. 2003;167:512-520.[Abstract/Free Full Text]
  • Oppert M., Reinicke A., Graf KJ, et al. Plasma cortisol levels before and during "low-dose" hydrocortisone therapy and their relationship to hemodynamic improvement in patients with septic shock. Intensive Care Med. 2000;26:1747-1755.[CrossRef][Medline] [Order article via Infotrieve]
  • Soni A., Pepper GM, Wyrwinski PM, et al. Adrenal insufficiency occurring during septic shock: incidence, outcome, and relationship to peripheral cytokine levels. Am J Med. 1995;98:266-271.[CrossRef][Medline] [Order article via Infotrieve]
  • Bone RC, Fisher CJJr, Clemmer TP, Slotman GJ, Metz CA Early methylprednisolone treatment for septic syndrome and the adult respiratory distress syndrome. Chest. 1987;92:1032-1036.[Abstract/Free Full Text]
  • Bernard GR, Luce JM, Sprung CL, et al. High-dose corticosteroids in patients with the adult respiratory distress syndrome. N Engl J Med. 1987;317:1565-1570.[Abstract]
  • Meduri GU, Headley AS, Golden E., et al. Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial. JAMA. 1998;280:159-165.[Abstract/Free Full Text]
  • Steinberg KP, Hudson LD, Goodman RB, et al. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med. 2006;354:1671-1684.[Abstract/Free Full Text]
  • Annane D., Sebille V., Bellissant E. Effect of low doses of corticosteroids in septic shock patients with or without early acute respiratory distress syndrome. Crit Care Med. 2006;34:22-30.[CrossRef][Medline] [Order article via Infotrieve]
  • Nakamori Y., Ogura H., Koh T., et al. The balance between expression of intranuclear NF-kappaB and glucocorticoid receptor in polymorphonuclear leukocytes in SIRS patients. J Trauma. 2005;59:308-314.[Medline] [Order article via Infotrieve]
  • Meduri GU, Muthiah MP, Carratu P., Eltorky M., Chrousos GP Nuclear factor-kappaB- and glucocorticoid receptor alpha- mediated mechanisms in the regulation of systemic and pulmonary inflammation during sepsis and acute respiratory distress syndrome: evidence for inflammation-induced target tissue resistance to glucocorticoids. Neuroimmunomodulation. 2005;12:321-338.[CrossRef][Medline] [Order article via Infotrieve]
  • Arlt W., Callies F., van Vlijmen JC, et al. Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med. 1999;341:1013-1020.[Abstract/Free Full Text]
  • Kim MS, Shigenaga J., Moser A., Grunfeld C., Feingold KR Suppression of DHEA sulfotransferase (Sult2A1) during the acute-phase response. Am J Physiol Endocrinol Metab. 2004;287:E731-E738.[Abstract/Free Full Text]
  • Zuckerman-Levin N., Tiosano D., Eisenhofer G., Bornstein S., Hochberg Z. The importance of adrenocortical glucocorticoids for adrenomedullary and physiological response to stress: a study in isolated glucocorticoid deficiency. J Clin Endocrinol Metab. 2001;86:5920-5924.[Abstract/Free Full Text]
  • Stewart PM Adrenal replacement therapy: time for an inward look to the medulla? J Clin Endocrinol Metab. 2004;89:3677-3678.[Free Full Text]
  • Bouachour G., Tirot P., Gouello JP, et al. Adrenocortical function during septic shock. Intensive Care Med. 1995;21: 57-62.[CrossRef][Medline] [Order article via Infotrieve]
  • Marik PE, Gayowski T., Starzl TE The hepatoadrenal syndrome: a common yet unrecognized clinical condition. Crit Care Med. 2005;33:1254-1259.[CrossRef][Medline] [Order article via Infotrieve]

Journal of Intensive Care Medicine, Vol. 22, No. 6, 348-362 (2007)
DOI: 10.1177/0885066607307832
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