Hormonal response following hemorrhage after severe trauma: an observational prospective study
Authors' conclusion
The vasopressin and renin-angiotensin-aldosterone systems are key pathways in the response to hemorrhage following severe trauma, and their response is quickly exhausted with its severity.
Study context
- Population
- Adult severe trauma patients (Injury Severity Score (ISS) ≥ 9), French level-1 trauma centermean age 46, median ISS 25
- Participants
- 65 patients
- Exposure
- Transfused vs non-transfused patients
- Transfusedn = 28
- Outcome
- Hypothalamic-posterior-pituitary-vasopressin, hypothalamic-pituitary-adrenal and renin-angiotensin-aldosterone system responses
- Follow-up
- First 48 h
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Copeptin (vasopressin secretion) at admission · admission
P < 0.001
- Copeptin evolution over 48 h differed between transfused and non-transfused (interaction)
- P < 0.001
- Copeptin evolution differed by hemorrhage severity (interaction)
- P < 0.001
- No difference in cortisol between transfused and non-transfused
- P = 0.06
Observational data: associations, not effects.
Further findings
Hemorrhage incidence · first 6 h
- Hemorrhage (≥1 pack of red blood cells (pRBC))
- 28 (43%)
- Severe hemorrhage (> 3 pRBC)
- 15 (23%)
Adrenal insufficiency · first 48 h
- Relative corticosteroid insufficiency
- 22
- Mineralocorticoid deficiency (aldosterone/renin < 2)
- 44
Original publication
Hormonal response following hemorrhage after severe trauma: an observational prospective study. Crit Care. Published 4 December 2025. doi:10.
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