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Fig. 2 | Critical Care

Fig. 2

From: Corticotropin-stimulated steroid profiles to predict shock development and mortality in sepsis: From the HYPRESS study

Fig. 2

Steroid profile at baseline (b) and 60 min (p) after corticotropin (Synacthen®) in severe sepsis without shock and healthy individuals. 11-Desoxycorticosterone at baseline and after stimulation was elevated in severe sepsis compared to healthy individuals (p < 0.01 Mann–Whitney test). Corticosterone at baseline did not differ between the groups. After stimulation with corticotropin (Synacthen®), corticosterone was significantly lower in sepsis (p < 0.0001). No differences were found for 17-OH-Progesterone (b and p). 11-Desoxycortisol (b and p) and cortisol (b and p) were significantly elevated in sepsis patients compared to healthy individuals indicating a shift toward cortisol synthesis in severe sepsis (all p < 0.0001). Cortisone at baseline was significantly lower in sepsis (p < 0.01) but not after stimulation with corticotropin. In severe sepsis, steroid profiling in combination with corticotropin testing showed activation of the glucocorticoid pathway and, in the mineralocorticoid pathway, an attenuated corticosterone biosynthesis despite high concentrations of its precursor

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