Comparative Studies on Adrenal Cortical Function and Cortisol Metabolism in Healthy Adults and in Patients with Shock Due to Infection

Abstract

Secretory failure of the adrenal glands has continued to be implicated as a factor in the pathogenesis of peripheral circulatory collapse due to infection since the original reports of Waterhouse (1) and of Friderichsen (2). This association of adrenal function and circulatory failure has been cited in recent reviews (3-5). However, a deficit of adrenal secretory products or their urinary metabolites in peripheral collapse due to infection has not been reported. Investigations in our laboratory have shown that shock produced in dogs by endotoxins of gram-negative bacteria was accompanied by an elevation of the concentration of cortisol in the plasma, and the output of cortisol in adrenal venous blood rose abruptly immediately after the injection of