Adrenal gland volume measurement in septic shock and control patients: a pilot study

Abstract

Objectives: To compare adrenal gland volume in septic shock patients and control patients by using semi-automated volumetry.

Methods: Adrenal gland volume and its inter-observer variability were measured with tomodensitometry using semi-automated software in 104 septic shock patients and in 40 control patients. The volumes of control and septic shock patients were compared and the relationship between volume and outcome in intensive care was studied.

Results: The mean total volume of both adrenal glands was 7.2 ± 2.0 cm(3) in control subjects and 13.3 ± 4.7 cm(3) for total adrenal gland volume in septic shock patients (p < 0.0001). Measurement reproducibility was excellent with a concordance correlation coefficient value of 0.87. The increasing adrenal gland volume was associated with a higher rate of survival in intensive care.

Conclusion: The present study reports that with semi-automated software, adrenal gland volume can be measured easily and reproducibly. Adrenal gland volume was found to be nearly double in sepsis compared with control patients. The absence of increased volume during sepsis would appear to be associated with a higher rate of mortality and may represent a prognosis factor which may help the clinician to guide their strategy.