Post-cardiac arrest syndrome: Mechanisms and evaluation of adrenal insufficiency

Table 1 Causes of post-cardiac arrest adrenal insufficiency

Adrenal gland ischemia and anoxia

Increased inflammatory response

Oxidative stress

Ischemia/reperfusion injury

Activation of apoptosis and programmed cell death

Malfunction of hypothalamic-pituitary-adrenal axis

Down-regulation of adrenal cell membrane receptors

Adrenomedullin secretion

Abnormalities in nitric oxide production

Drugs administered during cardiopulmonary resuscitation

Low levels of cortisol binding protein

Hypoalbuminemia