Abstract:
BACKGROUND:Physiological reactions of the stress hormone cortisol include hyperglycemia, hypertension, and endothelium dysfunction. In patients with aneurysmal subarachnoid hemorrhage (SAH), hyperglycemia, hypertension, and endothelium dysfunction are associated with the occurrence of delayed cerebral ischemia (DCI). Therefore, the purpose of the present study was to investigate whether increased serum cortisol levels after aneurysmal SAH are associated with DCI occurrence. METHODS:Blood samples were obtained at standard intervals after SAH. DCI was defined as the gradual onset of new focal neurological impairment, and/or a decreased level of consciousness of at least 2 points as recorded on the Glasgow Coma Scale. Correlation coefficients were calculated to investigate the associations between cortisol and serum glucose levels, and between cortisol and von Willebrand factor levels. RESULTS:Thirty-one patients were included. Eleven patients (35%) developed DCI. Signs of DCI started at a median of 6 days (range 4-10 days). Patients who developed DCI had significantly higher cortisol levels than patients without DCI (P = 0.006). Statistically significant, but weak, correlations were observed between cortisol and serum glucose levels (r = 0.216, P = 0.006), and cortisol and von Willebrand factor levels (r = 0.282, P < 0.001). CONCLUSIONS:Increased serum cortisol levels after SAH are associated with DCI occurrence and might be the link between the associations of hyperglycemia and endothelium dysfunction with DCI. It remains to be investigated whether the association between cortisol levels and DCI is independent from known prognostic baseline factors, such as amount of blood on admission CT scan.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Vergouwen MD,van Geloven N,de Haan RJ,Kruyt ND,Vermeulen M,Roos YBdoi
10.1007/s12028-010-9331-8subject
Has Abstractpub_date
2010-06-01 00:00:00pages
342-5issue
3eissn
1541-6933issn
1556-0961journal_volume
12pub_type
杂志文章,随机对照试验abstract:INTRODUCTION:The apnea test is a crucial component of the clinical diagnosis of brain death. Apprehension about hypoxemia, hypotension, and/or cardiac arrhythmias may sometimes lead clinicians to avoid performing or prematurely terminate the apnea test. The purpose of this study was to perform a contemporary re-evaluat...
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journal_title:Neurocritical care
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journal_title:Neurocritical care
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journal_title:Neurocritical care
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journal_title:Neurocritical care
pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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journal_title:Neurocritical care
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Neurocritical care
pub_type: 杂志文章
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journal_title:Neurocritical care
pub_type: 杂志文章
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更新日期:2012-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9400-z
更新日期:2010-10-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
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更新日期:2008-01-01 00:00:00
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