Corticosteroid therapy for patients in septic shock: some progress in a difficult decision

Corticosteroid therapy for patients in septic shock: Some progress in a difficult decision. Critical Care Medicine Vol 39(3), March 2011, p. 571-574

Sprung, C.L., et al.

http://journals.lww.com/ccmjournal/Abstract/2011/03000/Corticosteroid_therapy_for_patients_in_septic.20.aspx

Reversible adrenal insufficiency has been frequently diagnosed in critically ill patients with sepsis who have either low basal cortisol levels or low cortisol responses to adrenocorticotrophic hormone (ACTH) stimulation. It is generally accepted that a phenomenon called “endotoxin tolerance” contributes to immunosuppression during sepsis. The present study was to investigate whether endotoxin tolerance occurs in the adrenal gland, leading to hyporesponsiveness of adrenal gland during sepsis.