Echocardiographic features, mortality, and adrenal function in patients with cirrhosis and septic shock

Abstract

In a population with septic shock, left ventricular function was more hyperdynamic in the subset with cirrhosis. Relative adrenal insufficiency occurred in similar proportions of patients with and without cirrhosis.

Assessment of adrenal function in cirrhotic patients: Salivary cortisol should be preferred

“…Association of liver disease and adrenal insufficiency (AI), socalled hepatoadrenal syndrome, seems to be common in patients with severe cirrhosis admitted to intensive care units (ICU) [1][2][3][4][5][6] or not [7,8]. However, methods used to assess AI could be invalid in patients with cirrhosis.…”

High serum levels of free cortisol indicate severity of cirrhosis in hemodynamically stable patients

“…Several studies assessing adrenal function in cirrhotic patients using serum total cortisol (STC) 1–6 suggest that adrenal insufficiency (AI) is frequent, especially in patients with septic shock 5 . The standard‐dose short synacthen test (SD‐SST), which measures STC before and 60 min after an i.v.…”

Assessment of adrenal function in cirrhotic patients using concentration of serum-free and salivary cortisol

“…Few studies have assessed adrenal function in the context of liver disease (1)(2)(3)(4)(5)(6), but adrenal dysfunction has been reported with a high frequency of 77% in cirrhotic patients with septic shock (5). However, all studies evaluating adrenal function in critically ill cirrhotic patients are based on serum total cortisol concentration including the serum-free cortisol fraction, which is responsible for physiologic function (7), and the protein-bound cortisol fraction.…”