Value of free cortisol measurement in systemic infection.

摘要: Systemic infection induces an increase in plasma cortisol which accords approximately with illness severity. However, both basal and synthetic ACTH stimulated levels are not strong predictors of mortality. Moreover, do readily define those patients who have been clinically observed to respond, respect blood pressure elevation, exogenous hydrocortisone. It is likely that free cortisol, accounting for 6-20% circulating total (bound plus free) has most the life-saving effects on circulation metabolism severe sepsis, as corticosteroid-binding globulin bound albumin-bound reduced access tissues. In addition, sepsis reduces CBG albumin levels, hence blunting effect increasing severity cortisol. Our recent studies suggest correlates more closely than can be estimated using obviating need direct measurement. Studies directed at determining if a better guide hydrocortisone supplementation may value.