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Published in: Critical Care 4/2010

01-08-2010 | Commentary

Sepsis-related stress response: known knowns, known unknowns, and unknown unknowns

Authors: Jinmin Peng, Bin Du

Published in: Critical Care | Issue 4/2010

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Abstract

The hypothalamic-pituitary-adrenal (HPA) axis response in sepsis remains to be elucidated. Apart from corticotropin-releasing hormone, adrenocorticotropic hormone, and cortisol, many other neuroendocrine factors participate in the regulation of HPA stress response. The HPA response to acute and chronic illness exerts a biphasic profile. Tissue corticosteroid resistance may also play an important role. All of these add to the complexity of the concept of ‘relative adrenal insufficiency' and may account for the difficulty of clinical diagnosis and for the conflicting results of corticosteroid replacement therapy in severe sepsis/septic shock. The study by Lesur and colleagues expands our understanding of the mechanism, and further study of HPA stress response is warranted.
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Metadata
Title
Sepsis-related stress response: known knowns, known unknowns, and unknown unknowns
Authors
Jinmin Peng
Bin Du
Publication date
01-08-2010
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2010
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc9103

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