The adrenal gland responds to the stress of surgical procedures by an increase in cortical hormone output, and about 80% of these steroids are reported to be in the form of hydrocortisone—one of the 17-hydroxycorticoids. These substances are related to carbohydrate and protein metabolism, as well as having anti-inflammatory and antipyretic properties. The other 20% of adrenal output includes hormones, such as aldosterone, which primarily affect electrolyte and fluid balance.
Despite lack of knowledge of the way in which these hormones act on cells and of their disposition in body fluid compartments, it is becoming increasingly clear that there is a direct relation between liver function and adrenal corticoid metabolism. It has been shown1 that after infusions of hydrocortisone in normal subjects 50% of the hydrocortisone had left the plasma in 114 minutes. In patients with cirrhosis, however, it required 160 to 800 minutes for 50% of the steroid