title: The dynamic neuroendocrine response to critical illness.
abstract: The severity of striking alterations in the hypothalamic-anterior pituitary-peripheral hormone axes, which are the hallmark of severity of critical illness, is associated with a high risk for morbidity and mortality. Most attempts to correct the hormone balance are ineffective or harmful because of lack of pathophysiologic understanding. Extensive research has provided more insight in the biphasic neuroendocrine response to critical illness: the acute phase is characterized by an actively secreting pituitary but low peripheral effector hormone levels. In contrast, in prolonged critical illness, uniform suppression of the neuroendocrine axes, predominantly of hypothalamic origin, contributes to low serum levels of the respective target-organ hormones.
authors.affiliation: Department of Intensive Care Medicine, Katholieke Universiteit Leuven, Herestraat 49, B-300 Leuven, Belgium.
authors.forename: Lies
authors.initials: L
authors.lastname: Langouche
authors.forename: Greet
authors.initials: G
authors.lastname: Van den Berghe
mesh_terms: D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D009490:Neurosecretory Systems / Q000503:physiopathology*; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D013961:Thyroid Gland / Q000503:physiopathology