Basal Serum Cortisol Level and its Relation to the Severity of Critical Illness in Medical ICU Patients
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- Category: Vol. 85, June 2017
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Basal Serum Cortisol Level and its Relation to the Severity of Critical Illness in Medical ICU 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. During critical illness, many factors can impair the cortisol response to ACTH. Cortisol synthesis can be impaired by (pre-existing) disease of the hypothalamus, pituitary or adrenals, by infections, or by substrate deficiency.
Aim: To assess basal serum total cortisol levels in the study participants and to study its relation to disease severity as elicited by SAPS II Score. In addition the study aimed to shed the light on the CIRCI among the studied group.
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, at least 6% of studied population had Critical Illness Related Corticosteroid Insuf-ficiency (CIRCI) "cortisol less than 10mic/dl" and the majority of them (83.3%) died (5 out of 6).
Conclusion: There was no significant correlation between basal serum cortisol and SAPS II score (as an indicator for the severity of the critical illness). Mortality was higher in those having low cortisol less than 10mic/dl.