Critical illness Not Applicable
Conditions
Interventions
1. At the second day after admission to the ICU, patients will be evaluated on their appropriateness for the study and written informed consent will be obtained from the closest family member or legal
Sponsors
IWT Flanders (Agentschap voor Innovatie door Wetenschap en Techniek) (Belgium)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Intervention 1: 1. Patients: all patients admitted to the surgical and medical intensive care units of the university hospitals, Leuven, (Belgium), will be screened for inclusion when they are still mechanically ventilated at the 2nd, 3rd or 4th day after admission, provided that they do not meet one of the exclusion criteria below. 2. Healthy volunteers: Age-matched to the average age of the included patient population Added 25/10/2011: Intervention 2: 1. Patients: all patients with a urinary catheter, present at the surgical and medical intensive care units of the university hospitals, Leuven (Belgium). 2. Healthy volunteers: age-matched to the average age of the included patient population. Intervention 3: 1. Patients: critically ill patients who died in the intensive care unit and who undergo an autopsy. 2. Controls: non-critically ill persons who died in the emergency unit and who undergo an autopsy. Intervention 4: 1. Patients: patients receiving a bolus injection of hydrocortisone based on clinical indications. 2. Healthy volunteers: age matched to the average age of the included patient population.
Exclusion criteria
Exclusion criteria: Intervention 1 and 2: 1. Patients: 1.1. Age 75 years 2.2. Active malignancy 2.3. Pregnancy 2.4. Cerebral disease 2.5. (pan)Hypopituitarism 2.6. Known adrenal disease (Cushing or Addisson) 2.7. Systemic treatment with corticosteroids within the last 3 months Added 25/10/2011: Intervention 3: 1. Patients: 1.1. Age < 18 years 1.2. Cerebral disease 1.3. (pan)hypopituitarism 1.4. Known adrenal disease (Cushing or Addisson) 1.5. Systemic treatment with corticosteroids within the last 3 months before death 2. Controls 2.1. Critical illness or chronic disease 2.2. Cerebral disease 2.3. Systemic treatment with corticosteroids within the last 3 months before death Intervention 4: 1. Patients: 1.1. Age < 18 years 1.2. No arterial line in place 1.3. Ascites 2. Healthy volunteers: Same as for intervention 1
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Comparison between the secretion dynamics of cortisol and ACTH, and comparison with time series of inflammatory markers, will allow us to identify the main driving mechanisms for cortisol production during critical illness. Added 25/10/2011: 2. Comparison of the ratios of urinary cortisol metabolites will allow us to detect a difference in activity of the cortisol metabolizing enzymes between critically ill patients and healthy control persons. 3. We will study adrenal morphology and storage of lipid droplets, to detect the effect of critical illness associated endocrine changes on the adrenals. 4. Knowing the plasma half-live of cortisol during critical illness will allow us to gain correct deconvolution data. | — |
Countries
Belgium
Outcome results
None listed