A 50-year-old man on ICU has severe sepsis. His serum cortisol at 8 AM is measured as 180 nmol/L. He is not on any exogenous steroids. What does this cortisol level suggest in the context of critical illness? A Normal cortisol - no adrenal dysfunction B Critically low cortisol for the level of physiological stress - in critical illness, serum cortisol should be elevated (typically >500-700 nmol/L) due to the stress response; a random cortisol <275 nmol/L during critical illness suggests critical illness-related corticosteroid insufficiency (CIRCI) C The cortisol level is too high and indicates Cushing syndrome D Cortisol levels are unreliable in ICU - no interpretation is possible E This level only indicates adrenal insufficiency if the patient has symptoms
Check my answer
Educational content. Not a substitute for clinical judgement or local policy.