Endocrine Abstracts

Stress results in activation of the hypothalamic–pituitary–adrenal axis with increased circulating cortisol. It has been argued that a syndrome of ‘relative adrenal insufficiency’ is common in critically ill patients. Patients who fail to increase their cortisol by >250 nmol/30 min following the administration of 250 μg ACTH in the short synacthen test (SST) have been reported to have a higher mortality (JAMA 2000, 283 1038–1045)...

Patients with adrenal insufficiency require increased hydrocortisone (HC) replacement doses during surgery, trauma and infection to avoid life-threatening adrenal crisis. However, currently administered HC doses are chosen empirically rather than on rational grounds, with huge variability in administration modes, total dose and dosing intervals. To conclusively determine serum cortisol levels observed under stress conditions, we firstly collected blood samples from healthy con...

Patients with adrenal insufficiency (AI) require adjustment of hydrocortisone (HC) dose to avoid life-threatening adrenal crisis during illness, surgery and trauma. However, current dose recommendations are based on empirical grounds only and choice of dose and administration modes vary considerably. We designed the PACS study to compare cortisol levels achieved by currently recommended HC stress doses to those in i) healthy controls (n=85, 21–70 years), ii) mili...