UMEM Educational Pearls

Category: Critical Care

Title: ACTH Stimulation Test

Keywords: ACTH stimulation test, adrenal insufficency, corticosteroids (PubMed Search)

Posted: 4/8/2008 by Mike Winters, MD (Updated: 12/8/2022)
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ACTH Stimulation Test

  • With the recent publication of the CORTICUS study (along with others), it is becoming clear that the ACTH stimulation test is not reliable in identifying patients with adrenal insufficiency
  • In fact, the test is no longer recommended in the evaluation of patients with severe sepsis/septic shock
  • Furthermore, if you decide to give steroids to the patient with severe sepsis/septic shock, there is no need to use dexamethasone for fear of "disrupting the ACTH stim test" (hydrocortisone is the preferred agent)