ACTH and cortisol responses to CRH in acute, subacute, and prolonged critical illness: a randomized, double-blind, placebo-controlled, crossover cohort study

What Was Tested

This randomized controlled trial paper looks at ACTH (Corticotropin) and CRH (Corticotropin-Releasing Hormone).

Low plasma ACTH in critically ill patients may be explained by shock/inflammation-induced hypothalamus-pituitary damage or by feedback inhibition exerted by elevated plasma free cortisol.

Who Took Part

According to the abstract, 40 patients were involved.

The age groups tagged for this paper are middle-aged adults and older adults, both men and women.

How the Study Was Run

The design is described as randomized, double-blind, placebo-controlled and crossover.

Because people in this ACTH (Corticotropin) study were split into groups at random, differences between the groups are less likely to reflect who happened to join each one.

Blinding on both sides kept the patients and researchers unaware of who received ACTH (Corticotropin).

The comparison arm used a placebo, so changes seen with ACTH (Corticotropin) could be set against what happens without it.

In the crossover set-up each of the patients took both ACTH (Corticotropin) and the comparison in turn, acting as their own control.

CRH or placebo was injected in random order on two consecutive days.

Blood was sampled repeatedly over 135 min and AUC responses to placebo were subtracted from those to CRH.

What Was Measured

Topics PubMed links to this paper include Adrenocorticotropic Hormone, Cohort Studies, Corticotropin-Releasing Hormone, Critical Care, Critical Illness, Hormones and Hydrocortisone.

The authors tagged it with the keywords ACTH, CRH, Cortisol, Hypothalamus, Pituitary and Septic shock.

What This Means in Plain Language

The paper is a randomized, double-blind and placebo-controlled study of ACTH (Corticotropin) and CRH (Corticotropin-Releasing Hormone) in 40 patients.

Results are reported in around 4 sentences of the abstract; we leave them to the paper itself rather than summarise them.

The publication is from 2018 (Intensive care medicine), a journal based in United States.

More context: the ACTH (Corticotropin) compound page and the CRH (Corticotropin-Releasing Hormone) compound page, all human trials.