Pathophysiology
In a prospective study of 50 trauma patients [PMID:24975481], significant reductions in serum cortisol were observed both early after trauma and in the subsequent days, indicating a dynamic adrenal response affected by time post-injury.
Diagnosis
The study found no significant association between severe injury (injury severity score ≥ 16) and low serum cortisol levels (< 200 nmol/L) at any time point [PMID:24975481].
Management
Patients receiving continuous infusions of sedative/analgesic drugs had an eightfold higher odds of having serum cortisol levels below 200 nmol/L compared to those without such infusions [PMID:24975481].
References
1 Brorsson C, Dahlqvist P, Nilsson L, Thunberg J, Sylvan A, Naredi S. Adrenal response after trauma is affected by time after trauma and sedative/analgesic drugs. Injury 2014. link
1 papers cited of 3 indexed.