Format

Send to

Choose Destination
Intensive Care Med. 2006 Apr;32(4):595-8. Epub 2006 Jan 28.

Cortisol levels in patients with severe community-acquired pneumonia.

Author information

1
Medical-Surgical Intensive Care Unit, Instituto Nacional de Câncer, Centro de Tratamento Intensivo, Andar Rio de Janeiro, Brazil. jorgesalluh@yahoo.com.br

Abstract

OBJECTIVES:

To evaluate cortisol levels and prevalence of adrenal insufficiency in patients with severe community-acquired pneumonia (CAP).

DESIGN AND SETTING:

Retrospective cohort study in a 24-bed medical-surgical intensive care unit (ICU).

PATIENTS:

Forty patients with severe CAP admitted to the ICU from March 2003 and May 2005.

MEASUREMENTS AND RESULTS:

Random cortisol levels were measured up to 72 h after ICU admission. A threshold of 20 microg/dl was considered for the diagnosis of adrenal insufficiency. Median cortisol levels were 15.5 microg/dl (IQR 10.8-25.1), and 26 patients (65%) met the criteria for adrenal insufficiency. Other cutoff levels of cortisol were evaluated, and 30 patients (75%) had cortisol levels below 25 microg/dl and 19 (47.5%) had cortisol levels below 15 microg/dl. When only patients with septic shock (n=19) were evaluated, 12 (63%) had adrenal insufficiency.

CONCLUSIONS:

Relative adrenal insufficiency occurs in a high proportion of patients with severe CAP. This finding highlights the importance of measuring cortisol levels and may help explain the potential benefits of hydrocortisone infusion in these patients.

PMID:
16552616
DOI:
10.1007/s00134-005-0046-9
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center