Elevated Plasma-Free Cortisol Concentrations and Ratios Are Associated With Increased Mortality Even in the Presence of Statin Therapy in Patients With Severe Sepsis
Balasubramanian Venkatesh, Lee Imeson, Peter Kruger, Jeremy Cohen, Mark Jones, Rinaldo Bellomo
Critical Care Medicine | LIPPINCOTT WILLIAMS & WILKINS | Published : 2015
BACKGROUND: Dissociation between plasma-free cortisol and total cortisol profiles exists in critical illness. Data on plasma-free cortisol are based on either calculated values or immunoassay-based measurements. Both have significant limitations. Statins have been advocated as a therapy in sepsis. Whether they impact on plasma cortisol through inhibition of cholesterol synthesis is unclear. OBJECTIVES: In patients enrolled into a randomized trial of statins in sepsis (n = 250), we examined the association of mass spectrometry measured plasma-free cortisol, plasma-free cortisol/plasma total cortisol ratios, and outcome and the impact of concomitant statin therapy on cortisol profiles in 80 st..View full abstract
Awarded by Australian National Health and Medical Research Council
Supported, in part, by a research grant (project grant no. 436873) from the Australian National Health and Medical Research Council.Dr. Venkatesh received royalties for authoring a book and received support for travel (study leave support by Queensland Health). His institution received grant support from the National Health and Medical Research Council (NHMRC). Dr. Kruger received royalties from Elsevier (coauthor-book on critical care radiology). His institution received grant support from NHMRC (peer-reviewed research grant funded main study). The remaining authors have disclosed that they do not have any potential conflicts of interest.