Study of the Prevalence of CIRCI in Medical ICU Patients in Septic vs Non Septic Patients
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- Category: Vol. 85, June 2017
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Study of the Prevalence of CIRCI in Medical ICU Patients in Septic vs Non Septic Patients, MONA A. RADWAN, SOAD A. SOLTAN, RAGAI M. FIKRY, WALAA A. RABIE and SAMEH G. SAYED
Abstract
Background: Critical illness or life-threatening disease initiates various adaptive responses in the human body to maintain body homeostasis. One of the body's most important regulatory systems needed to achieve these responses is the Hypothalamic-Pituitary-Adrenal (HPA) axis. Despite the controversy regarding the cutoff value for diagnosing adrenal insufficiency in critically ill patients, the American College of Critical Care of Medicine in 2008 recommended that Critical Illness Related Corticosteroid Insufficiency (CIRCI) is best diagnosed by a random total cortisol level <10mcg/dl or an incremental response <9mcg/dl after standard 250mcg corticotrophin stimulation test, the so-called delta cortisol.
Aim: To assess basal serum cortisol in the study participant and to study the prevalence of CIRCI in medical ICU patients (septic vs. non septic).
Patients and Methods: A prospective observational study was done in Kasr Al-Ainy University Hospital, Cairo, Egypt; basal serum total cortisol was determined in 100 medical ICU patients (septic and non septic) using Radioimuunoassay (RIA).
Results: Mean basal serum total cortisol level in the studied patients was 25.7±8ug/dL. Mean basal serum total cortisol level in the studied non septic patients was 26±9ug/dL. Mean basal serum total cortisol level in the studied septic patients was 27±11ug/dL. Mean basal serum total cortisol level in the studied septic shock patients was 24.2±10ug/dL. Patients having basal serum cortisol less than 10ug/dL was 6% of whole population studied, constituting about 10% of septic patients, 25% of those having septic shock.
Conclusions: There was no statistical significant difference between mean serum total cortisol level in septic and non-septic studied patients. Patients having basal serum cortisol less than 10ug/dL (definite CIRCI) was 6% of whole population studied, constituting about 10% of septic patients, 25% of those having septic shock.