The Journal of clinical endocrinology and metabolism
The most recent articles from:
May 2020
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J. Clin. Endocrinol. Metab. · May 2020
Dynamic Pituitary-Adrenal Interactions in the Critically Ill after Cardiac Surgery.
Patients with critical illness are thought to be at risk of adrenal insufficiency. There are no models of dynamic hypothalamic-pituitary-adrenal (HPA) axis function in this group of patients and thus current methods of diagnosis are based on aggregated, static models. ⋯ This study supports the premise that current tests of HPA axis function are unhelpful in the diagnosis of adrenal insufficiency in the CI. The reduced ACTH and increase in nonpulsatile cortisol secretion imply that the secretion of cortisol is driven by factors outside the HPA axis in critical illness.