Hypothalamo-pituitary-adrenal axis activity after intracranial catastrophies: what is enough?

Abstract:

:This commentary on a paper by Bendel and colleagues in the previous issue of Critical Care describes the difficulty in assessing the sufficiency of adrenal responses to endogenous, stress-induced adrenocorticotropic hormone (ACTH) release by the pituitary or to exogenous ACTH administration in the critically ill patient in general, and after subarachnoid hemorrhage in particular. It is argued that comparisons with responses under circumstances of equal stress as well as assessments of severity of disease are necessary to judge the sufficiency of cortisol responses to endogenous and exogenous ACTH before treatment is considered. There are no universally applicable cutoff values for cortisol levels--and increases in cortisol levels with increasing levels of ACTH--for the diagnosis of relative adrenal insufficiency (or as it is now commonly termed, critical illnes-related corticosteroid insufficiency) following, for example, subarachnoid hemorrhage or other intracranial catastrophes. The paper by Bendel and colleagues is critically discussed in view of these concepts.

journal_name

Crit Care

authors

Groeneveld AB,Beishuizen A,Molenaar N

doi

10.1186/cc7131

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

103

issue

1

eissn

1364-8535

issn

1466-609X

pii

cc7131

journal_volume

13

pub_type

评论,杂志文章,评审
  • Drotrecogin alfa (activated): does current evidence support treatment for any patients with severe sepsis?

    abstract::Two international multicentre randomised controlled trials of drotrecogin alfa (activated) (DrotAA), the Recombinant Human Activated Protein C Worldwide Evaluation of Severe Sepsis (PROWESS) and Administration of Drotrecogin Alfa (Activated) in Early Stage Severe Sepsis (ADDRESS) trials, have produced inconsistent res...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc4947

    authors: Friedrich JO,Adhikari NK,Meade MO

    更新日期:2006-01-01 00:00:00

  • End of life care in Brazil: the long and winding road.

    abstract::Disagreements between the perceptions of nurses and physicians regarding end-of-life (EOL) decisions are frequent. In a survey carried out in 13 Brazilian ICUs, Fumis and Deheinzelin reported that the majority of nurses, physicians and family members are in favor of limiting life-sustaining therapies in terminally ill...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc9962

    authors: Soares M

    更新日期:2011-01-01 00:00:00

  • Prehospital point of care testing of blood gases and electrolytes - an evaluation of IRMA.

    abstract::BACKGROUND: This study evaluated the feasibility of blood gas analysis and electrolyte measurements during emergency transport prior to hospital admission. RESULTS: A portable, battery-powered blood analyzer was used on patients in life threatening conditions to determine pH, pCO2, pO2, sodium, potassium and ionized c...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc108

    authors: Prause G,Ratzenhofer-Komenda B,Offner A,Lauda P,Voit H,Pojer H

    更新日期:1997-01-01 00:00:00

  • Bench-to-bedside review: circulating microparticles--a new player in sepsis?

    abstract::In sepsis, inflammation and thrombosis are both the cause and the result of interactions between circulating (for example, leukocytes and platelets), endothelial and smooth muscle cells. Microparticles are proinflammatory and procoagulant fragments originating from plasma membrane generated after cellular activation a...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc9231

    authors: Meziani F,Delabranche X,Asfar P,Toti F

    更新日期:2010-01-01 00:00:00

  • Effect of perioperative sodium bicarbonate administration on renal function following cardiac surgery for infective endocarditis: a randomized, placebo-controlled trial.

    abstract:BACKGROUND:Patients with infective endocarditis (IE) have an elevated risk of renal dysfunction because of extensive systemic inflammation and use of nephrotoxic antibiotics. In this randomized, placebo-controlled trial, we investigated whether perioperative sodium bicarbonate administration could attenuate postoperati...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/s13054-016-1591-z

    authors: Cho JS,Soh S,Shim JK,Kang S,Choi H,Kwak YL

    更新日期:2017-01-05 00:00:00

  • Marked regional endothelial dysfunction in mottled skin area in patients with severe infections.

    abstract:BACKGROUND:Mottling around the knee, reflecting a reduced skin blood flow, is predictive of mortality in patients with septic shock. However, the causative pathophysiology of mottling remains unknown. We hypothesized that the cutaneous hypoperfusion observed in the mottled area is related to regional endothelial dysfun...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-017-1742-x

    authors: Bourcier S,Joffre J,Dubée V,Preda G,Baudel JL,Bigé N,Leblanc G,Levy BI,Guidet B,Maury E,Ait-Oufella H

    更新日期:2017-06-23 00:00:00

  • Association between hospital volume and network membership and an analgesia, sedation and delirium order set quality score: a cohort study.

    abstract:INTRODUCTION:Protocols for the delivery of analgesia, sedation and delirium care of the critically ill, mechanically ventilated patient have been shown to improve outcomes but are not uniformly used. The extent to which elements of analgesia, sedation and delirium guidelines are incorporated into order sets at hospital...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc11390

    authors: Dale CR,Hayden SJ,Treggiari MM,Curtis JR,Seymour CW,Yanez ND 3rd,Fan VS

    更新日期:2012-06-18 00:00:00

  • Targeting the programmed cell death 1: programmed cell death ligand 1 pathway reverses T cell exhaustion in patients with sepsis.

    abstract:INTRODUCTION:A major pathophysiologic mechanism in sepsis is impaired host immunity which results in failure to eradicate invading pathogens and increased susceptibility to secondary infections. Although many immunosuppressive mechanisms exist, increased expression of the inhibitory receptor programmed cell death 1 (PD...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13176

    authors: Chang K,Svabek C,Vazquez-Guillamet C,Sato B,Rasche D,Wilson S,Robbins P,Ulbrandt N,Suzich J,Green J,Patera AC,Blair W,Krishnan S,Hotchkiss R

    更新日期:2014-01-04 00:00:00

  • Comparison of mortality prediction models in acute respiratory distress syndrome undergoing extracorporeal membrane oxygenation and development of a novel prediction score: the PREdiction of Survival on ECMO Therapy-Score (PRESET-Score).

    abstract:BACKGROUND:Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy in acute respiratory distress syndrome (ARDS) patients but is associated with complications and costs. Here, we validate various scores supposed to predict mortality and develop an optimized categorical model. METHODS:In a derivation cohort...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-017-1888-6

    authors: Hilder M,Herbstreit F,Adamzik M,Beiderlinden M,Bürschen M,Peters J,Frey UH

    更新日期:2017-12-12 00:00:00

  • Results from the national sepsis practice survey: predictions about mortality and morbidity and recommendations for limitation of care orders.

    abstract:INTRODUCTION:Critically ill patients and families rely upon physicians to provide estimates of prognosis and recommendations for care. Little is known about patient and clinician factors which influence these predictions. The association between these predictions and recommendations for continued aggressive care is als...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7926

    authors: O'Brien JM Jr,Aberegg SK,Ali NA,Diette GB,Lemeshow S

    更新日期:2009-01-01 00:00:00

  • Potential confounders for the effect of high-flow nasal cannula oxygen therapy.

    abstract:: ...

    journal_title:Critical care (London, England)

    pub_type: 评论,信件

    doi:10.1186/s13054-019-2310-3

    authors: Yamaga S,Ohshimo S,Shime N

    更新日期:2019-01-17 00:00:00

  • Impaired Ca(2+) release contributes to muscle weakness in a rat model of critical illness myopathy.

    abstract:BACKGROUND:Critical illness myopathy is an acquired skeletal muscle disorder with severe myosin loss and muscle weakness frequently seen in intensive care unit (ICU) patients. It is unknown if impaired excitation-contraction coupling contributes to the muscle weakness. METHODS:We used a unique ICU model where rats wer...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1417-z

    authors: Llano-Diez M,Cheng AJ,Jonsson W,Ivarsson N,Westerblad H,Sun V,Cacciani N,Larsson L,Bruton J

    更新日期:2016-08-10 00:00:00

  • Changes in pulse pressure variability during cardiac resynchronization therapy in mechanically ventilated patients.

    abstract:INTRODUCTION:The respiratory variation in pulse pressure (PP) has been established as a dynamic variable of cardiac preload which indicates fluid responsiveness in mechanically ventilated patients. The impact of acute changes in cardiac performance on respiratory fluctuations in PP has not been evaluated until now. We ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc5779

    authors: Keyl C,Stockinger J,Laule S,Staier K,Schiebeling-Römer J,Wiesenack C

    更新日期:2007-01-01 00:00:00

  • A longitudinal study highlights shared aspects of the transcriptomic response to cardiogenic and septic shock.

    abstract:BACKGROUND:Septic shock (SS) and cardiogenic shock (CS) are two types of circulatory shock with a different etiology. Several studies have described the molecular alterations in SS patients, whereas the molecular factors involved in CS have been poorly investigated. We aimed to assess in the whole blood of CS and SS pa...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-019-2670-8

    authors: Braga D,Barcella M,Herpain A,Aletti F,Kistler EB,Bollen Pinto B,Bendjelid K,Barlassina C

    更新日期:2019-12-19 00:00:00

  • Omega-3 fatty acid-containing parenteral nutrition in ICU patients: systematic review with meta-analysis and cost-effectiveness analysis.

    abstract:BACKGROUND:Omega-3 (ω-3) fatty acid (FA)-containing parenteral nutrition (PN) is associated with significant improvements in patient outcomes compared with standard PN regimens without ω-3 FA lipid emulsions. Here, we evaluate the impact of ω-3 FA-containing PN versus standard PN on clinical outcomes and costs in adult...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03356-w

    authors: Pradelli L,Klek S,Mayer K,Omar Alsaleh AJ,Rosenthal MD,Heller AR,Muscaritoli M

    更新日期:2020-11-03 00:00:00

  • Rapid response systems: you won't know there is a problem until you measure it.

    abstract::The rapid response system concept is one of the first patient-centered and organizational-wide systems aimed at preventing deaths and serious adverse events. It has been strongly argued that we need a benchmark that reflects the care of a deteriorating patient across the organization using a 'score to door time'; that...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc10477

    authors: Hillman KM

    更新日期:2011-01-01 00:00:00

  • Systemic endotoxin activity correlates with clot formation: an observational study in patients with early systemic inflammation and sepsis.

    abstract:INTRODUCTION:Inflammation and coagulation are closely linked, and both can be triggered by endotoxin. Thrombelastometry and impedance aggregometry are of diagnostic and predictive value in critically ill patients. In this observational study we investigated the correlation of endotoxin activity with thrombelasometric a...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc12892

    authors: Koch A,Meesters MI,Scheller B,Boer C,Zacharowski K

    更新日期:2013-09-11 00:00:00

  • Early drotrecogin alpha (activated) administration in severe sepsis is associated with lower mortality: a retrospective analysis of the Canadian ENHANCE cohort.

    abstract:INTRODUCTION:Early multimodal treatment of severe sepsis, including the use of drotrecogin alfa (activated) (DrotAA) when indicated, is considered essential for optimum outcome. However, predicting which infected patients will progress to severe sepsis and the need for aggressive intervention continues to be problemati...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc7893

    authors: Hodder RV,Hall R,Russell JA,Fisher HN,Lee B

    更新日期:2009-01-01 00:00:00

  • Does pulse pressure variation predict fluid responsiveness in critically ill patients? A systematic review and meta-analysis.

    abstract:INTRODUCTION:Fluid resuscitation is crucial in managing hemodynamically unstable patients. The last decade witnessed the use of pulse pressure variation (PPV) to predict fluid responsiveness. However, as far as we know, no systematic review and meta-analysis has been carried out to evaluate the value of PPV in predicti...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/s13054-014-0650-6

    authors: Yang X,Du B

    更新日期:2014-11-27 00:00:00

  • Long term effect of a medical emergency team on cardiac arrests in a teaching hospital.

    abstract:INTRODUCTION:It is unknown whether the reported short-term reduction in cardiac arrests associated with the introduction of the medical emergency team (MET) system can be sustained. METHOD:We conducted a prospective, controlled before-and-after examination of the effect of a MET system on the long-term incidence of ca...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3906

    authors: Jones D,Bellomo R,Bates S,Warrillow S,Goldsmith D,Hart G,Opdam H,Gutteridge G

    更新日期:2005-01-01 00:00:00

  • Endothelin antagonists in subarachnoid hemorrhage: what next?

    abstract::In the previous issue of Critical Care, Ma and colleagues perform a meta-analysis of five randomized, clinical trials of endothelin antagonists in patients with aneurysmal subarachnoid hemorrhage. There are four trials using clazosentan and one trial with TAK-044. These studies show that endothelin plays an important ...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc11822

    authors: Macdonald RL

    更新日期:2012-11-09 00:00:00

  • Alternative protocol to initiate high-frequency oscillatory ventilation: an experimental study.

    abstract:INTRODUCTION:The objective was to study the effects of a novel lung volume optimization procedure (LVOP) using high-frequency oscillatory ventilation (HFOV) upon gas exchange, the transpulmonary pressure (TPP), and hemodynamics in a porcine model of surfactant depletion. METHODS:With institutional review board approva...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc5052

    authors: Karmrodt J,David M,Yuan S,Markstaller K

    更新日期:2006-01-01 00:00:00

  • Oxygen deficit and H2S in hemorrhagic shock in rats.

    abstract:INTRODUCTION:Hemorrhagic shock induced O2 deficit triggers inflammation and multiple organ failure (MOF). Endogenous H2S has been proposed to be involved in MOF since plasma H2S concentration appears to increase in various types of shocks and to predict mortality. We tested the hypothesis that H2S increases during hemo...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc11661

    authors: Van de Louw A,Haouzi P

    更新日期:2012-10-02 00:00:00

  • A practical approach to goal-directed echocardiography in the critical care setting.

    abstract::Urgent cardiac ultrasound examination in the critical care setting is clinically useful. Application of goal-directed echocardiography in this setting is quite distinct from typical exploratory diagnostic comprehensive echocardiography, because the urgent critical care setting mandates a goal-directed approach. Goal-d...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-014-0681-z

    authors: Walley PE,Walley KR,Goodgame B,Punjabi V,Sirounis D

    更新日期:2014-12-01 00:00:00

  • Microcirculatory perfusion disturbances following cardiopulmonary bypass: a systematic review.

    abstract:BACKGROUND:Microcirculatory perfusion disturbances are associated with increased morbidity and mortality in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Technological advancements made it possible to monitor sublingual microcirculatory perfusion over time. The goal of this review is to provide...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-02948-w

    authors: den Os MM,van den Brom CE,van Leeuwen ALI,Dekker NAM

    更新日期:2020-05-13 00:00:00

  • Duration of diaphragmatic inactivity after endotracheal intubation of critically ill patients.

    abstract:BACKGROUND:In patients intubated for mechanical ventilation, prolonged diaphragm inactivity could lead to weakness and poor outcome. Time to resume a minimal diaphragm activity may be related to sedation practice and patient severity. METHODS:Prospective observational study in critically ill patients. Diaphragm electr...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03435-y

    authors: Sklar MC,Madotto F,Jonkman A,Rauseo M,Soliman I,Damiani LF,Telias I,Dubo S,Chen L,Rittayamai N,Chen GQ,Goligher EC,Dres M,Coudroy R,Pham T,Artigas RM,Friedrich JO,Sinderby C,Heunks L,Brochard L

    更新日期:2021-01-11 00:00:00

  • In vivo calibration of esophageal pressure in the mechanically ventilated patient makes measurements reliable.

    abstract:BACKGROUND:Esophageal pressure (Pes) can provide information to guide mechanical ventilation in acute respiratory failure. However, both relative changes and absolute values of Pes can be affected by inappropriate filling of the esophageal balloon and by the elastance of the esophagus wall. We evaluated the feasibility...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1278-5

    authors: Mojoli F,Iotti GA,Torriglia F,Pozzi M,Volta CA,Bianzina S,Braschi A,Brochard L

    更新日期:2016-04-11 00:00:00

  • Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicenter prospective study.

    abstract:INTRODUCTION:Sepsis, severe sepsis and septic shock are common conditions with high mortality. Their early diagnosis in the Emergency Department (ED) is one of the keys to improving survival. Procalcitonin (PCT) has been used as a biomarker in septic patients but has limited specificity and can be elevated in other sce...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc12847

    authors: Ulla M,Pizzolato E,Lucchiari M,Loiacono M,Soardo F,Forno D,Morello F,Lupia E,Moiraghi C,Mengozzi G,Battista S

    更新日期:2013-07-30 00:00:00

  • Roundtable debate: Controversies in the management of the septic patient--desperately seeking consensus.

    abstract::Despite continuous advances in technologic and pharmacologic management, the mortality rate from septic shock remains high. Care of patients with sepsis includes measures to support the circulatory system and treat the underlying infection. There is a substantial body of knowledge indicating that fluid resuscitation, ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc2940

    authors: Waxman AB,Ward N,Thompson T,Lilly CM,Lisbon A,Hill N,Nasraway SA,Heard S,Corwin H,Levy M

    更新日期:2005-08-20 00:00:00

  • Impact of HIV/AIDS on care and outcomes of severe sepsis.

    abstract:INTRODUCTION:There has been dramatic improvement in survival for patients with HIV/AIDS; however, some studies on patients with HIV/AIDS and serious illness have reported continued low rates of intensive care. The purpose of this study was to examine patterns of care and outcomes for patients with severe sepsis and HIV...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3811

    authors: Mrus JM,Braun L,Yi MS,Linde-Zwirble WT,Johnston JA

    更新日期:2005-01-01 00:00:00