Compared with controls , in severe sepsis , baseline plasma total cortisol was elevated two-fold ( @ nmol/L -LSB- @-@ nmol/L -RSB- vs @ nmol/L -LSB- @-@ nmol/L -RSB- , p < @ ) , plasma-free cortisol @-fold ( @ nmol/L -LSB- @-@ nmol/L -RSB- vs @ nmol/L -LSB- @-@ nmol/L -RSB- , p < @ ) , and plasma-free cortisol/plasma total cortisol ratio six-fold ( @ vs @ , p = @ ) .