Plasma cortisol levels in Guillain-Barré syndrome
| Autor: | Christian Devaux, Djillali Annane, Julian Strauss, Jean-Luis Gaillard, Jerome Aboab, Andrea Polito, David Orlikowski, Raphaël Porcher, Leon Ikka, Martin Rottmann, Tarek Sharshar, Frédéric Lofaso, Marie-Christine Durand |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Hydrocortisone medicine.drug_class Primary Dysautonomias Critical Care and Intensive Care Medicine Guillain-Barre Syndrome law.invention law Predictive Value of Tests Intensive care Internal medicine Sepsis medicine Humans Prospective Studies Prospective cohort study business.industry Odds ratio Middle Aged Intensive care unit Endocrinology Early Diagnosis Logistic Models Respiratory failure Anesthesia Multivariate Analysis Corticosteroid Cytokines Female Adrenal Cortex Function Tests France business Respiratory Insufficiency Glucocorticoid Biomarkers medicine.drug Adrenal Insufficiency Hyponatremia |
| Zdroj: | Critical care medicine. 37(8) |
| ISSN: | 1530-0293 |
| Popis: | OBJECTIVE To assess the relationship between plasma cortisol level and Guillain-Barre syndrome-related complications, notably respiratory failure. One third of patients with Guillain-Barre syndrome develop respiratory failure, which is predicted by few early indicators. Adrenal function has rarely been studied in Guillain-Barre syndrome. DESIGN Prospective study. SETTING Intensive care unit in a teaching hospital. PATIENTS Patients with Guillain-Barre syndrome referred to our unit (n = 102). INTERVENTIONS Plasma cortisol levels were measured before baseline and 60 mins after corticotrophin test in 93 patients with Guillain-Barre syndrome at admission, 16 (17%) of whom were ventilated within 24 hrs from admission, 17 (18%) ventilated after the 24th hr and 60 (65%) never ventilated. MEASUREMENTS AND MAIN RESULTS Mean plasma cortisol levels at baseline and 60 mins after corticotrophin test were 22.9 +/- 11.3 ng/mL and 45.4 +/- 16.1 ng/mL. At baseline, the plasma cortisol levels were significantly higher in 17 (18%) patients, who developed respiratory failure at least 24 hrs later (28.5 +/- 12.1 ng/mL vs. 20.4 +/- 9.6 ng/mL; p = .003) and dysautonomia (33.1 +/- 14.3 ng/mL vs. 21.4 +/- 10.2 ng/mL, p = .003). When adjusting on only validated clinical predictors (i.e., delay between onset and admission |
| Databáze: | OpenAIRE |
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