کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5896548 | 1154979 | 2011 | 15 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Adrenocortical (dys)function in septic shock - A sick euadrenal state
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موضوعات مرتبط
علوم زیستی و بیوفناوری
بیوشیمی، ژنتیک و زیست شناسی مولکولی
علوم غدد
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چکیده انگلیسی
A central feature of the endocrine pathophysiology of septic shock is thought to be the existence of adrenal dysfunction. Based on changes in glucocorticoid secretion and responsiveness, protein binding, and activity. These changes have been described by the terms “Relative Adrenal Insufficiency” (RAI), or “Critical Illness Related Corticosteroid Insufficiency” (CIRCI), and form part of the rationale for trials of glucocorticoid treatment in septic shock.5 Diagnostic criteria for these conditions have been based on plasma cortisol profiles and have proven notoriously difficult to establish. The uncertainty in this area arises from the inability of current tests to clearly identify who is truly glucocorticoid “deficient” at a cellular level, and hence who requires supplemental glucocorticoid administration. Emerging data suggest that there may be abnormalities in the tissue activity of glucocorticoids in patients with severe sepsis and plasma profiles may not be reliable indicators of tissue glucocorticoid activity, We put forward an alternative point of view, that is the spectrum of adrenocortical dysfunction in sepsis - plasma and tissue, can be grouped under the umbrella of a “sick euadrenal syndrome” rather than an adrenocortical insufficiency.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Best Practice & Research Clinical Endocrinology & Metabolism - Volume 25, Issue 5, October 2011, Pages 719-733
Journal: Best Practice & Research Clinical Endocrinology & Metabolism - Volume 25, Issue 5, October 2011, Pages 719-733
نویسندگان
Bala (Professor of Intensive Care), Jeremy (Staff Specialist in Intensive Care),