Dataset Information

ACTH and cortisol responses to CRH in acute, subacute, and prolonged critical illness: a randomized, double-blind, placebo-controlled, crossover cohort study.

ABSTRACT: PURPOSE:Low plasma ACTH in critically ill patients may be explained by shock/inflammation-induced hypothalamus-pituitary damage or by feedback inhibition exerted by elevated plasma free cortisol. One can expect augmented/prolonged ACTH-responses to CRH injection with hypothalamic damage, immediately suppressed responses with pituitary damage, and delayed decreased responses in prolonged critical illness with feedback inhibition. METHODS:This randomized, double-blind, placebo-controlled crossover cohort study, compared ACTH responses to 100 µg IV CRH and placebo in 3 cohorts of 40 matched patients in the acute (ICU-day 3-6), subacute (ICU-day 7-16) or prolonged phase (ICU-day 17-28) of critical illness, with 20 demographically matched healthy subjects. CRH or placebo was injected in random order on two consecutive days. Blood was sampled repeatedly over 135 min and AUC responses to placebo were subtracted from those to CRH. RESULTS:Patients had normal mean?±?SEM plasma ACTH concentrations (25.5?±?1.6 versus 24.8?±?3.6 pg/ml in healthy subjects, P?=?0.54) but elevated free cortisol concentrations (3.11?±?0.27 versus 0.58?±?0.05 µg/dl in healthy subjects, P?

SUBMITTER: Peeters B

PROVIDER: S-EPMC6280831 | biostudies-other | 2018 Oct

REPOSITORIES: biostudies-other

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ACTH and cortisol responses to CRH in acute, subacute, and prolonged critical illness: a randomized, double-blind, placebo-controlled, crossover cohort study.

Peeters Bram B Meersseman Philippe P Vander Perre Sarah S Wouters Pieter J PJ Debaveye Yves Y Langouche Lies L Van den Berghe Greet G

Intensive care medicine 20181029 12

<h4>Purpose</h4>Low plasma ACTH in critically ill patients may be explained by shock/inflammation-induced hypothalamus-pituitary damage or by feedback inhibition exerted by elevated plasma free cortisol. One can expect augmented/prolonged ACTH-responses to CRH injection with hypothalamic damage, immediately suppressed responses with pituitary damage, and delayed decreased responses in prolonged critical illness with feedback inhibition.<h4>Methods</h4>This randomized, double-blind, placebo-contr ...[more]

PMID: 30374692

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Dataset Information

ACTH and cortisol responses to CRH in acute, subacute, and prolonged critical illness: a randomized, double-blind, placebo-controlled, crossover cohort study.

Publications

ACTH and cortisol responses to CRH in acute, subacute, and prolonged critical illness: a randomized, double-blind, placebo-controlled, crossover cohort study.

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