Endocrine Abstracts

Purpose: Sepsis is hallmarked by high circulating glucocorticoids in face of low plasma adrenocorticotropic hormone (ACTH) (1). At the hypothalamic-pituitary level, ongoing stress-induced corticotropin-releasing hormone- (CRH) and arginine vasopressin- (AVP) driven expression of the ACTH-precursor POMC coincides with impaired proprotein convertase 1 (PC1/3)-mediated processing into ACTH, with ultimately leaching of unprocessed POMC into the circulation (2). Despite uncertainty...

Aim of the work: The time courses of ACTH, (free) cortisol and cortisol metabolites beyond the first week of critical illness and upon recovery have not been documented. We studied adrenocortical function over time in relation to critical illness duration and presence of sepsis/septic shock, to initiation of glucocorticoid treatment, and to recovery/death.Methods: Patients still in ICU on day 7 (N=392) and 20 matched healthy subjects were includ...