POMC and systemic inflammatory response syndrome: Even though disease severity diminished in time in this selected cohort, the number of patients with subnormal ACTH responses only slightly decreased and tended to relate to persistent or new occurrence of SIRS and culture-positive sepsis and coagulation disturbances (prolonged aPTT), in line with other investigators suggesting sepsis as the main risk factor for adrenal dysfunction of the critically ill [3,6,7,9-14,18,26-28].