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Vasopressin increases cortisol levels independent of ACTH or catecholamine stimulation in a porcine model of septic shock
Author(s) -
Sung Chen Li,
Hashiro Glenn M,
Hernandez Claudia A,
Claybaugh John R,
Uyehara Catherine F T
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a514
Subject(s) - septic shock , medicine , endocrinology , vasopressin , aldosterone , catecholamine , glucocorticoid , adrenal insufficiency , norepinephrine , adrenal gland , epinephrine , hydrocortisone , stimulation , basal (medicine) , hormone , shock (circulatory) , sepsis , dopamine , insulin
Adrenal insufficiency is a concern in the management of septic shock. Recently, vasopressin (VP) has demonstrated clinical utility in catecholamine‐resistant septic shock by increasing blood pressure and redirecting blood flow to vital organs. In this study we tested the hypothesis that VP may also be beneficial by stimulating catecholamine secretion or adrenal function. Thus, in our porcine model of endotoxin‐induced septic shock, adrenal steroid hormone levels were compared between untreated controls (n=7) and pigs treated with VP (100 ng/kg/min, i.v.; n=8). Endotoxin caused an ACTH‐induced increase in cortisol (5.6 ± 0.6 μg/dl basal vs 17.8 ± 1.6 μg/dl, n=15, p<0.01). While the endotoxin‐induced cortisol increase remained constant in untreated pigs, VP significantly further increased cortisol levels (27.3±1.9 μg/dl; p<0.01) independent of any associated increase in ACTH. The direct effect of VP on the adrenal gland was glucocorticoid‐specific, as aldosterone, epinephrine, norepinephrine, and dopamine levels were not elevated by VP. This direct stimulation of cortisol could have important clinical implications in the treatment of adrenal insufficiency and glucose metabolism in septic shock. Supported by USAMRMC CDMRP grant DAMD17‐03‐1‐0072 .