Glucocorticoid Response to Intramuscular Acth Stimulation in Critically Ill Patients

Abstract

BACKGROUNDCortisol (Glucocorticoid) is the main hormone in host response to stress. Its secretion from adrenal glands depends on integrity of hypothalamic-pituitary-adrenal (HPA) axis. Adrenocorticotropic hormone (ACTH) is the stimulant for cortisol secretion from adrenal glands. Adrenal insufficiency (AI) is often present in critically ill patients and is diagnosed by ACTH stimulation test using intravenous (IV) injection of Synacthen (Tetracosactide) which is not freely available in our part. Another synthetic corticotrophin (Acton Prolongatum) prepared by Ferring pharmaceuticals can be used for intramuscular (IM) ACTH stimulation test for assessment of adrenal function. Aims & Objectives-To measure the basal serum cortisol level at 8.00-9.00 a.m. then at 60 min. & 3 hours after IM ACTH stimulation and to find out glucocorticoid response in critically ill patients.