Compared with controls , in severe sepsis , baseline plasma total cortisol was elevated two-fold ( 463 nmol/L [ 284-742 nmol/L ] vs 245 nmol/L [ 200-299 nmol/L ] , p < 0.001 ) , plasma-free cortisol 20-fold ( 75 nmol/L [ 20-151 nmol/L ] vs 5 nmol/L [ 5-7 nmol/L ] , p < 0.001 ) , and plasma-free cortisol/plasma total cortisol ratio six-fold ( 0.15 vs 0.02 , p = 0.058 ) .