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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ann+Intensive+Care
2011 ; 1
(ä): 53
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Disturbances of the hypothalamic-pituitary-adrenal axis and plasma electrolytes
during experimental sepsis
#MMPMID22208725
Flierl MA
; Rittirsch D
; Weckbach S
; Huber-Lang M
; Ipaktchi K
; Ward PA
; Stahel PF
Ann Intensive Care
2011[Dec]; 1
(ä): 53
PMID22208725
show ga
BACKGROUND: Sepsis continues to be a poorly understood syndrome with a high
mortality rate. While we are beginning to decipher the intricate interplay of the
inflammatory response during sepsis, the precise regulation of the
hypothalamic-pituitary-adrenal (HPA) axis and its impact on electrolyte
homeostasis during sepsis remains incompletely understood. METHODS: Sepsis was
induced in adult male Sprague-Dawley rats by cecal ligation and puncture (CLP).
Plasma samples were obtained as a function of time (6-48 hrs) after CLP and
compared with healthy animals (neg ctrl). Samples were analyzed for
adrenocorticotropin (ACTH), corticosterone, and aldosterone levels, as well as
concentrations of sodium (Na+), potassium (K+), chloride (Cl-), and magnesium
(Mg2+). RESULTS: ACTH levels were found to be significantly reduced 6-24 hrs
after CLP in comparison to baseline levels and displayed gradual recovery during
the later course (24-48 hrs) of sepsis. Plasma corticosterone concentrations
exhibited a bell-shaped response, peaking between 6 and 12 hrs followed by rapid
decline and concentrations below negative control levels 48 hrs after injury.
Aldosterone levels in septic animals were continuously elevated between 6 and 48
hrs. Whereas plasma Na+ levels were found to be persistently elevated following
CLP, levels of K+, Cl- and Mg2+ were significantly reduced as a function of time
and gradually recovered during the later course of sepsis. CONCLUSIONS:
CLP-induced sepsis resulted in dynamic changes of ACTH, corticosterone, and
aldosterone levels. In addition, electrolyte levels showed significant
disturbances after CLP. These electrolyte perturbations might be evoked by a
downstream effect or a dysfunctional HPA-axis response during sepsis and
contribute to severe complications during sepsis.