ArticleCritical care (London, England)2009
Critical illness-related corticosteroid insufficiency in patients with severe acute biliary pancreatitis: a prospective cohort study.
Article in Critical care (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 31 citations in OpenAlex.
- The effect of Chaiqin Chengqi Decoction () on modulating serum matrix metalloproteinase 9 in patients with severe acute pancreatitis.Chinese journal of integrative medicine · 2013Trial
- Disulfiram Protects Against Multiorgan Injuries and Cell Pyroptosis via Inhibiting GSDMD in Severe Acute Pancreatitis Mice.Journal of cellular and molecular medicine · 2025Article
- Corticosteroid treatment for acute/acute-on-chronic experimental and naturally occurring pancreatitis in several species: a scoping review to inform possible use in dogs.Acta veterinaria Scandinavica · 2021Article
- ACVIM consensus statement on pancreatitis in cats.Journal of veterinary internal medicine · 2021Article
- Risk factors for corticosteroid insufficiency during the sub-acute phase of acute traumatic brain injury.Neural regeneration research · 2020Article
- New Roles for Corticosteroid Binding Globulin and Opposite Expression Profiles in Lung and Liver.PloS one · 2016Article
- An ex vivo RT-qPCR-based assay for human peripheral leukocyte responsiveness to glucocorticoids in surgically induced inflammation.Journal of inflammation research · 2015Article
- Stress-dose hydrocortisone reduces critical illness-related corticosteroid insufficiency associated with severe traumatic brain injury in rats.Critical care (London, England) · 2013Article
- Changes of inflammation and apoptosis in adrenal gland after experimental injury in rats with acute necrotizing pancreatitis.Inflammation · 2012Article
- The adrenocorticotropic hormone-induced cortisol response in acute pancreatitis.Critical care (London, England) · 2009Article
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12 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionGallstones are the most common cause of acute pancreatitis worldwide. Patients with severe acute biliary pancreatitis (SABP) constitute a subgroup of severe acute pancreatitis (SAP) patients in whom systemic inflammation may be triggered and perpetuated by different mechanisms. The aim of this prospective investigation was to examine the adrenal response to corticotropin and the relationship between adrenal function and outcome in patients with SABP.
methodsThirty-two patients with SABP were enrolled in this study. A short corticotropin (250 microg) stimulation test (SST) was performed within the first 24 hours of admission to the ICU. Critical illness related corticosteroid insufficiency (CIRCI) was defined as follows: baseline value less than 10 microg/dL, or cortisol response less than 9 microg/dL.
resultsCIRCI occurred in 34.4% of patients. The patients with CIRCI were more severely ill as evidenced by higher APACHE II and SOFA scores and numbers of organ system dysfunction on the day of SST. The in-hospital mortality for the entire group was 21.9%. The CIRCI group had a higher hospital mortality rate compared to those with normal adrenal function (45.5% vs. 9.5%, P = 0.032). The hospital survivors had a higher cortisol response to corticotropin (17.4 (8.3-27.1) vs. 7.2 (1.7-12) microg/dL, P = 0.019). The cortisol response to corticotropin inversely correlated with SOFA score and the number of organ dysfunction on the day of SST. The rates of pancreatic necrosis and bacteremia were significantly higher in the CIRCI group (100% vs 42.9%, P = 0.002; 81.8% vs 23.8%, P = 0.003, respectively).
conclusionsCIRCI is common in patients with SABP. It is associated with bacteremia, multiple organ dysfunction and increased mortality.
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