Endocrine Abstracts

Critical illness is hallmarked by hypercortisolemia, traditionally attributed to stress-induced hypothalamic–pituitary–adrenal axis activation. However, as low plasma ACTH concentrations and reduced responsiveness to ACTH have been reported, we hypothesized that reduced cortisol metabolism could play a major role. To systematically test this hypothesis, we recently performed six studies in matched ICU patients and healthy controls. These measured daily ACTH and corti...

Recently, the concept that stress hyperglycemia in critically ill patients is an adaptive, beneficial response has been challenged. Two large randomized studies demonstrated that maintenance of normoglycemia with intensive insulin therapy substantially prevents morbidity and reduces mortality in these patients. Since then, questions have been raised about the efficacy in general and in specific subgroups, and about the safety of this therapy with regard to potential harm of br...

Introduction: Patients in need of an intensive care unit (ICU) treatment due to severe diseases often develop the non-thyroidal illness syndrome (NTI). These critically ill patients present with low thyroxine (T4), low 3,3’,5-triiodothyronine (T3) and elevated reverse T3 (rT3) serum concentrations while TSH and 3,3’-diiodothyronine (3,3’-T2) concentrations remain unaffected. To further elucidate the underlying changes ...