Evaluation of function of pituitary gland in patients with septic shock and the effect of low-dose corticosteroid therapy

There is evidence for the usefulness of low-dose corticosteroids for relative adrenal insufficiency in septic shock. Treatment with low-dose corticosteroid was found to have beneficial effects on hemodynamics and outcome. Relative adrenal insufficiency is often diagnosed by the adrenocorticotropic hormone (ACTH) stimulation test, but it is impossible to evaluate the function of the whole hypothalamus-pituitary-adrenal axis, so there might be possibility to miss the patients who need steroids due to disability of pituitary gland or hypothalamus.