solucortef use in hypotensive pt

Specialties MICU

Published

Specializes in med surg, ccu, icu, nursg home, md offic.

Can anyone explain how solucortef increased BP. I think it stimulates the adrenals to secrete cortisol but not sure. I have been told that it "expands the vasculature" but don't understand.

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Specializes in NICU, PICU, PCVICU and peds oncology.

This article may help you understand the mechanism of action:

http://www.medscape.com/viewarticle/441925_4

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Specializes in CCU/CVU/ICU.
Can anyone explain how solucortef increased BP. I think it stimulates the adrenals to secrete cortisol but not sure. I have been told that it "expands the vasculature" but don't understand.

I'm unsure of the specific vapors, humors, and phlegms behind the BP-regulating function of cortisol but i do know that it's not a simple matter of volume expansion. Cortisol has more of a 'metabolic' rather than 'mechanical' effect on BP...if that makes sense (it's very early here).

But...what I am sure of is that it's not going to improve hypotension in someone who's not adrenal insufficient. For example, it wont do a thing for cardiogenic or hypovolemic shock...BUT it can help (and sometimes dramatically) in certain distributive (esp. septic) shock-states...or any other incidence where the adrenals are failing. MANY patients in septic-shock have depressed adrenals...

But...to make my early morning...long-winded answer short... Cortisol administration only helps improve BP if adrenal insufficiency is causing and/or otherwise involved in the hypotension. And...it's more than a simple matter of volume expansion.

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