Plasma Cortisol: Time to Look Deeper? [chapter]

J. Cohen, J. Prins, B. Venkatesh
Intensive Care Medicine  
Cortisol, the major glucocorticoid synthesized by the adrenal cortex plays a pivotal role in normal metabolism. Its secretion is under the control of the hypothalamic pituitary axis. There are a variety of stimuli to secretion, including stress, tissue damage, cytokine release, hypoxia, hypotension and hypoglycemia. These factors act upon the hypothalamus to favor the release of corticotropin releasing hormone (CRH) and vasopressin. These in turn stimulate the secretion of ACTH, which
more » ... TH, which stimulates the release of cortisol, mineralocorticoids (principally aldosterone), and androgens from the adrenal cortex. During periods of stress, trauma or infection, there is an increase in CRH and ACTH secretion and a reduction in the negative feedback effect, resulting in increased cortisol levels, in amounts roughly proportional to the severity of the illness [6 -8].
doi:10.1007/978-0-387-49518-7_11 fatcat:filjujd7xndwjausa6tkxuelyi