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Title of Journal: Intensive Care Med

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Abbravation: Intensive Care Medicine

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Springer-Verlag

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DOI

10.1007/bf01476530

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1432-1238

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The lowdose corticotropin stimulation test in acu

Authors: Ioanna Dimopoulou Stylianos Tsagarakis Evangelia Douka Maria Zervou Andreas T Kouyialis Urania Dafni Nikolaos Thalassinos Charis Roussos
Publish Date: 2004/04/21
Volume: 30, Issue: 6, Pages: 1216-1219
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Abstract

Blood was taken on day 16 median after admission to the ICU to determine baseline cortisol and ACTH Thereafter a lowdose stimulation test LDST was performed 1 µg of tetracosactrin was injected and 30 min later a second blood specimen was obtained to measure stimulated cortisol Patients having a stimulated cortisol below 500 nmol/l were defined as nonresponders to the LDSTMedian baseline and stimulated cortisol were 491 nmol/l and 690 nmol/l respectively The median increment in cortisol was 154 nmol/l range 5–579 nmol/l Mean ACTH was 46±21 pg/ml Ten 13 patients were nonresponders to the LDST these had a higher mortality rate compared to patients with adequate cortisol production 70 vs 32 p=0034 Logistic regression analysis revealed that APACHE II p0001 Glasgow Coma Scale GCS p=004 and age p=002 were independent outcome predictors In contrast the increment in cortisol p=026 did not add to outcome prediction

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