Adrenocortical function in patients with ruptured aneurysm of the abdominal aorta
| Autor: | Hans P. F. Koppeschaar, H. D. W. M. van de Pavoordt, R. Braams, T. J. M. V. van Vroonhoven |
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| Rok vydání: | 1998 |
| Předmět: |
Male
medicine.medical_specialty genetic structures Hydrocortisone Aortic Rupture Critical Illness Critical Care and Intensive Care Medicine Aneurysm Postoperative Complications Adrenocorticotropic Hormone medicine.artery Adrenal insufficiency Medicine Humans Etomidate cardiovascular diseases Aorta Abdominal Prospective Studies Adrenocortical Insufficiency APACHE Aged Aged 80 and over Aorta business.industry Vascular disease Abdominal aorta Middle Aged medicine.disease Pathophysiology Hormones Surgery cardiovascular system Cosyntropin Female business Complication Anesthetics Intravenous Adrenal Insufficiency |
| Zdroj: | Intensive care medicine. 24(2) |
| ISSN: | 0342-4642 |
| Popis: | To investigate adrenocortical function in patients with ruptured aneurysm of the abdominal aorta.Prospective clinical investigation.Surgical intensive care unit in a university teaching hospital and intensive care unit in a general hospital.54 patients with a documented rupture of the abdominal aorta.A short adrenocorticotrophic hormone (ACTH) stimulation test was performed.Patients were studied within 24 h of admission to the hospital. Blood samples for the measurement of cortisol and ACTH were collected at 0800 h. Subsequently 0.25 mg tetracosactrin (Synacthen) was injected i.v. and after 60 min cortisol measurement was repeated. The criterion for a normal short ACTH test was: stimulated or unstimulated cortisol levelsor = 0.55 mumol/l. For the group as a whole, an unstimulated plasma cortisol level of 0.76 mumol/l was comparable to that in other groups of critically ill patients with similar severity of illness. Between survivors and non survivors, significant differences were found between unstimulated plasma cortisol levels (0.70 vs 1.03 mumol/l), stimulated plasma cortisol levels (1.00 vs 1.30 mumol/l), and plasma ACTH levels (72 vs 133 ng/l). One patient did not meet the criteria for normal adrenocortical function: unstimulated plasma cortisol 0.26 mumol/l, stimulated plasma cortisol 0.47 mumol/l.In the patients studied with ruptured aneurysm of the abdominal aorta, adrenocortical response was comparable to that in other groups of critically ill patients with similar severity of illness. High cortisol levels were associated with mortality. One patient did not meet the criteria for normal adrenocortical function but survival without steroid treatment. |
| Databáze: | OpenAIRE |
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