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Objectives:

To measure tissue glucocorticoid sensitivity in patients with septic shock and determine its relationship to standard measurements of adrenal function and of outcome.

Design:

Prospective observational trial.

Setting:

Teaching hospital ICU.

Subjects:

Forty-one patients and 20 controls were studied.

Interventions:

Glucocorticoid sensitivity was measured by in vitro suppression of cytokine production from lipopolysaccharide-stimulated leukocytes.

Measurements and Main Results:

There was no significant difference between the groups in the relative suppression of cytokine production, although there was a greater range and variance in the patient data. Patients in the lowest quartile of glucocorticoid sensitivity had higher Acute Physiology and Chronic Health Evaluation II scores (25 [24–28] vs 20 [14–23]; p= 0.02) and a trend toward higher mortality (30% vs 0%; p= 0.2) compared to those in the highest. The …