The relationship between early post‐operative ACTH / cortisol following pituitary surgery and long‐term glucocorticoid requirement – Do ultradian rhythms matter?
| Autor: | Christina Jang, Katherine English, Viral Chikani, Goce Dimeski, Sara H. Olson, Warrick J. Inder |
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| Rok vydání: | 2021 |
| Předmět: |
Hypothalamo-Hypophyseal System
endocrine system medicine.medical_specialty Cortisol awakening response Hydrocortisone Endocrinology Diabetes and Metabolism Pituitary-Adrenal System 030209 endocrinology & metabolism Hypopituitarism Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Endocrinology Adrenocorticotropic Hormone Internal medicine Humans Medicine Circadian rhythm Glucocorticoids Ultradian rhythm Morning business.industry Ultradian Rhythm medicine.disease Pituitary Gland 030220 oncology & carcinogenesis Cohort business hormones hormone substitutes and hormone antagonists Glucocorticoid medicine.drug |
| Zdroj: | Clinical Endocrinology. 94:636-644 |
| ISSN: | 1365-2265 0300-0664 |
| Popis: | OBJECTIVE To determine whether early (4-8h) post-operative ACTH after trans-sphenoidal surgery (TSS) predicts long-term hypothalamic-pituitary-adrenal (HPA) axis function and to investigate early morning day 1 ACTH/cortisol variability using rapid sampling. DESIGN Prospective observational study. METHODS Participants undergoing TSS were included; those treated with glucocorticoids pre-operatively received 100 mg intravenous hydrocortisone on anaesthetic induction. ACTH and cortisol were measured post-operatively at + 4h and + 8h after induction and on day 1 every 10 minutes between 0700h and 0900h. PRIMARY OUTCOME glucocorticoid requirement at 6 months. RESULTS Nineteen participants (10F, 9M): 6/19 (32%) were treated with replacement glucocorticoids pre-operatively; 4 had ceased by 6 weeks post-operatively. One patient developed new hypopituitarism post-operatively meaning 3/19 (16%) required glucocorticoids at 6 months. Post-operative + 4h ACTH |
| Databáze: | OpenAIRE |
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