[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-457476-105":3,"doc-detail-457476-en":81,"detail-sidebar-cat-0-en-105":99},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","hormonal-response-following-hemorrhage-after-severe-trauma-an-observational-prospective-study","Hormonal response following hemorrhage after severe trauma - an observational prospective study","","Severe trauma triggers autonomic and neuroendocrine activation to limit hemorrhage-related falls in blood pressure and organ perfusion, yet hormonal adaptation pathways remain insufficiently characterized in this context. This study explored hypothalamic-posterior-pituitary-vasopressin, hypothalamic–pituitary–adrenal, and renin–angiotensin–aldosterone responses in adults with severe trauma, linking hormonal biomarkers to transfusion exposure and hemorrhage severity.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/hormonal-response-following-hemorrhage-after-severe-trauma-an-observational-prospective-study/457476/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/hormonal-response-following-hemorrhage-after-severe-trauma-an-observational-prospective-study/457476.png","ImageObject",300,407,{"name":42,"@type":43},"Elsa","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What hormonal systems were the focus of this study after severe trauma hemorrhage?","Question",{"text":63,"@type":64},"The study focused on the hypothalamic-posterior-pituitary-vasopressin system, the hypothalamic–pituitary–adrenal axis, and the renin–angiotensin–aldosterone system.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was hemorrhage defined in terms of transfusion for the study results?",{"text":68,"@type":64},"Hemorrhage was characterized by transfusion of at least one pack of red blood cells in the first 6 hours, and severe hemorrhage by more than 3 packs in that same time window.",{"name":70,"@type":61,"acceptedAnswer":71},"What did the study find about copeptin (a vasopressin surrogate) over time?",{"text":72,"@type":64},"Copeptin peaked at admission and was higher in transfused than in non-transfused patients. It then rapidly decreased, with no significant differences between groups from 6 hours after admission.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},457476,1790902619,{"code":4,"msg":82,"data":83},"success",{"doc_id":79,"user_id":84,"nickname":42,"user_avatar":85,"doc_module":4,"category_id":86,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":87,"file_id":88,"file_url":89,"file_type":90,"file_size":91,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":92,"language":93,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":94,"faqs":95,"seo_title":96,"seo_description":12,"update_tm":97,"read_time":98,"preview_page_count":4},137455077381,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d",7,"Werner et al. Critical Care (2026) 30:14 Critical Care  \n[https://doi.org/10.1186/s13054-025-05782-0](https://doi.org/10.1186/s13054-025-05782-0)  \nRESEARCH Open Access  \nHormonal response following hemorrhage after severe trauma: an observational  \nprospective study  \nMarie Werner 1,2*, Hadrien Joulia 1, Eric Pussard3, Benjamin Bergis 1,2, Pierre-Etienne Leblanc 1, Lucille Wildenberg 1, Alice Huertas2, Bernard Vigué 1, Jacques Duranteau 1,2 and Anatole Harrois 1,2  \nAbstract  \nBackground Following severe trauma, activation of the autonomic and neuroendocrine systems is key in the response to hemorrhage by triggering vasopressor secretion, sodium and water reabsorption to maintain blood pressure and organ perfusion. However, these adaptative mechanisms remain not yet well described in this setting. The main goal ofthis study was to explore hypothalamic-posterior-pituitary-vasopressin, hypothalamic–pituitary– adrenal and renin–angiotensin–aldosterone system responses to severe trauma.  \nMethods This is a single-centre prospective observational study among adult severe trauma patients (Injury Severity Score (ISS) ≥ 9) in a French level-1 trauma center.  \nResults Sixty-five patients were included with a mean age of 46 (± 20) years old and a median ISS of 25 (19–30) . Twenty-eight (43%) patients presented with a hemorrhage (transfusion of at least one pack of red blood cells (pRBC) in the 6 first hours), and 15 (23%) of them had a severe hemorrhage (> 3 pRBC in the first 6 h) . Evolution of copeptin level, reflecting vasopressin secretion, was significantly different over the 48 h between transfused and non-transfused patients (interaction; P \u003C 0. 001) and regarding hemorrhage severity (no transfusion, 1–3 pRBC, > 3 pRBC) (interaction; P \u003C 0. 001) . Copeptin was maximum at admission and higher in transfused than in non-transfused patients (486 ± 433 pmol/L vs.208 ± 206 pmol/L; P \u003C 0. 001) . It rapidly decreased without significant difference anymore between groups from 6 h after admission. Renin (time effect, P = 0 . 001; transfusion effect, P = 0 . 02; interaction, P = 0 . 04) and aldosterone (time effect, P \u003C 0. 001; transfusion effect, P = 0 . 7; interaction, P = 0 . 08) were significantly different over the first 48 h regarding hemorrhage severity. There was no difference between transfused and non-transfused patients regarding levels of cortisol (P = 0 . 06) . Twenty-two patients presented a relative corticosteroid insufficiency and 44 presented mineralocorticoid deficiency (aldosterone/renin \u003C 2) over the first 48 h.  \nConclusions 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. This study strengthens the pathophysiological rationale for exploring personalized vasopressor management, including the timely addition of vasopressin and/or angiotensin II in addition to norepinephrine during the resuscitation of traumatic hemorrhage.  \n*Correspondence: Marie Werner [marie.werner@aphp.fr](marie.werner@aphp.fr)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permi","cbCaipBoWJcIlgTP","https://ap.wps.com/l/cbCaipBoWJcIlgTP","pdf",1346815,11,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Keywords\n# Background","[{\"question\":\"What hormonal systems were the focus of this study after severe trauma hemorrhage?\",\"answer\":\"The study focused on the hypothalamic-posterior-pituitary-vasopressin system, the hypothalamic–pituitary–adrenal axis, and the renin–angiotensin–aldosterone system.\"},{\"question\":\"How was hemorrhage defined in terms of transfusion for the study results?\",\"answer\":\"Hemorrhage was characterized by transfusion of at least one pack of red blood cells in the first 6 hours, and severe hemorrhage by more than 3 packs in that same time window.\"},{\"question\":\"What did the study find about copeptin (a vasopressin surrogate) over time?\",\"answer\":\"Copeptin peaked at admission and was higher in transfused than in non-transfused patients. It then rapidly decreased, with no significant differences between groups from 6 hours after admission.\"}]","Hormonal response following hemorrhage after severe trauma - an observational prospective study | PDF",1790749452,28,{"code":4,"msg":82,"data":100},[101,105,109,113,118,123,126,130,135,138,142],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":110,"show_sort_weight":111,"slug":112},"Exam",70,"exam",{"id":114,"doc_module":4,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},5,"Comic",60,"comic",{"id":119,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},6,"Technology",50,"technology",{"id":86,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":124,"slug":125},40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":127,"show_sort_weight":128,"slug":129},"Research & Report",30,"research-report",{"id":131,"doc_module":4,"doc_module_name":25,"category_name":132,"show_sort_weight":133,"slug":134},9,"Religion & Spirituality",20,"religion-spirituality",{"id":133,"doc_module":4,"doc_module_name":25,"category_name":136,"show_sort_weight":133,"slug":137},"World Cup","world-cup",{"id":139,"doc_module":4,"doc_module_name":25,"category_name":140,"show_sort_weight":139,"slug":141},10,"Lifestyle","lifestyle",{"id":143,"doc_module":4,"doc_module_name":25,"category_name":144,"show_sort_weight":114,"slug":145},19,"General","general"]