Comparative Studies on Adrenal Cortical Function and Cortisol Metabolism in Healthy Adults and in Patients with Shock Due to Infection

Abstract

Adrenal function was studied in 17 healthy adults and in 22 adult patients having shock due to infection. Three quantitative studies were employed. First, the basal plasma cortisol level was determined. Second, the response of the adrenal to stimulation with corticotropin was measured in terms of change in plasma cortisol concentration. Third, the biological half-time of exogenous cortisol injected as the succinate ester in plasma was evaluated. All shock patients had considerably higher basal plasma cortisol concentrations than did healthy subjects. In 6 patients with shock there was a response to corticotropin similar to that obtained in healthy adults. The biological half-time of exogenous cortisol was not different from healthy subjects in those patients with shock who survived, but in those patients having fatal shock the biological half-time was considerably more prolonged than that observed in healthy subjects. Accelerated adrenal secretory activity was demonstrated in those patients who survived. In moribund patients unequivocal proof for increased adrenal secretory activity could not be obtained.