Pituitary-adrenal function in patients with acute subarachnoid haemorrhage: a prospective cohort study.

Abstract:

INTRODUCTION:Subarachnoid haemorrhage (SAH) may damage the hypothalamo-pituitary-adrenal gland (HPA) axis and disturb cortisol metabolism. There are no available data that relates to the response of the HPA axis in the acute phase of SAH. We aimed to characterise the behavior of serum adrenocorticotropic hormone (ACTH), total cortisol, stimulated total cortisol and free cortisol concentrations in acute aneurysmal SAH. METHODS:A prospective cohort study was conducted of patients with acute aneurysmal SAH (n = 30) admitted to a tertiary university hospital. Patients admitted for elective aneurysmal surgery (n = 16) served as the control group. An ACTH stimulation test was performed twice during the first week and at three months. The main outcome measure was description of the ACTH-cortisol response by calculating serum free cortisol and measuring total cortisol and ACTH concentrations. A mixed models method was used for testing between the groups, allowing heterogeneity between the groups. RESULTS:Patients with SAH had higher initial serum total cortisol (mean +/- SD; 793 +/- 312 nmol/L) and free cortisol concentrations (83 +/- 55 nmol/L) than control patients (535 +/- 193 nmol/L, p = 0.001 and 33 +/- 18 nmol/L, p < 0.001, respectively). Thereafter, there were no differences in this respect. Serum free and total cortisol concentrations correlated but were unaffected by the severity of SAH. ACTH concentrations were comparable between SAH and control groups. Patients with Hunt-Hess grades IV to V had higher ACTH concentrations at day one (10.7 +/- 7.1 pmol/l/L) and day five (8.2 +/- 7.7 pmol/L) than patients with grade I-III (day one: 3.8 +/- 2.0 pmol/L, p = 0.002; day five: 4.7 +/- 1.8 pmol/L, p = 0.04). CONCLUSIONS:Calculation of serum free cortisol concentration was not helpful in identifying patients with potential hypocortisolism. SAH severity did not affect cortisol concentrations, possibly indicating relative pituitary-adrenal insufficiency in patients with more severe bleeding. TRIAL REGISTRATION:ClinicalTrials.gov Identifier NCT00614887.

journal_name

Crit Care

authors

Bendel S,Koivisto T,Ruokonen E,Rinne J,Romppanen J,Vauhkonen I,Kiviniemi V,Uusaro A

doi

10.1186/cc7084

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

R126

issue

5

eissn

1364-8535

issn

1466-609X

pii

cc7084

journal_volume

12

pub_type

杂志文章
  • Inhaled nitric oxide and the risk of renal dysfunction in patients with acute respiratory distress syndrome: a propensity-matched cohort study.

    abstract:BACKGROUND:Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1566-0

    authors: Ruan SY,Wu HY,Lin HH,Wu HD,Yu CJ,Lai MS

    更新日期:2016-11-30 00:00:00

  • Prediction of ventilation weaning outcome: children are not little adults.

    abstract::Prediction of ventilation weaning outcome in children is important, as unsuccessful extubation increases both morbidity and mortality. Adult weaning criteria are poor predictors of weaning outcome in children for several possible reasons: the length of mechanical ventilation is generally much shorter, and the weaning ...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc3950

    authors: Schindler MB

    更新日期:2005-01-01 00:00:00

  • Recent progress in sepsis epidemiology--have we learned enough?

    abstract::The encouraging results of recent clinical trials on therapy of severe sepsis and septic shock are paralleled by ongoing studies on the epidemiology of sepsis and infection in intensive care unit patients all over the world. The development of network-based systems for assessing morbidity and mortality in intensive ca...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc2175

    authors: Gerlach H,Keh D

    更新日期:2003-10-01 00:00:00

  • "Think. Check. Submit." to avoid predatory publishing.

    abstract:: ...

    journal_title:Critical care (London, England)

    pub_type: 信件

    doi:10.1186/s13054-018-2244-1

    authors: Cortegiani A,Shafer SL

    更新日期:2018-11-14 00:00:00

  • Drotrecogin alfa (recombinant human activated protein C) in severe acute pancreatitis.

    abstract:INTRODUCTION:Current concepts of the pathophysiology of acute pancreatitis suggest that disease progression from acinar injury to systemic illness involves a complex interplay between cellular and soluble inflammatory mediators and endothelial beds. To date, there is no specific pharmacologic intervention for acute pan...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3777

    authors: Jamdar S,Siriwardena AK

    更新日期:2005-08-01 00:00:00

  • Semi-elemental versus polymeric formula for enteral nutrition in brain-injured critically ill patients: a randomized trial.

    abstract:BACKGROUND:The properties of semi-elemental enteral nutrition might theoretically improve gastrointestinal tolerance in brain-injured patients, known to suffer gastroparesis. The purpose of this study was to compare the efficacy and tolerance of a semi-elemental versus a polymeric formula for enteral nutrition (EN) in ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03456-7

    authors: Carteron L,Samain E,Winiszewski H,Blasco G,Balon AS,Gilli C,Piton G,Capellier G,Pili-Floury S,Besch G

    更新日期:2021-01-20 00:00:00

  • The brain after critical illness: effect of illness and aging on cognitive function.

    abstract::Large numbers of patients who survive critical illness are left with significant new cognitive impairments that are often severe and remain years after hospital discharge. In the previous issue of Critical Care, Guerra and colleagues assessed risk factors for the development of dementia after an intensive care unit (I...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc11913

    authors: Hopkins RO

    更新日期:2013-02-06 00:00:00

  • A week seems to be weak: tailoring duration of antibiotic treatment in Gram-negative ventilator-associated pneumonia.

    abstract::The optimal length of antimicrobial therapy has not been extensively studied for a great majority of infections and, in critically ill patients affected by ventilator-associated pneumonia, is a persisting and unsolved issue confronting clinicians. The integration of biomarkers, clinical judgment, and microbiologic era...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc11899

    authors: Martin-Loeches I,Torres A

    更新日期:2013-01-21 00:00:00

  • Utility of thromboelastography and/or thromboelastometry in adults with sepsis: a systematic review.

    abstract:INTRODUCTION:Coagulation abnormalities are frequent in sepsis. Conventional coagulation assays, however, have several limitations. A surge of interest exists in the use of point-of-care tests to diagnose hypo- and hypercoagulability in sepsis. METHODS:MEDLINE, EMBASE, and the Cochrane Library were searched from 1 Janu...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc13721

    authors: Müller MC,Meijers JC,Vroom MB,Juffermans NP

    更新日期:2014-02-10 00:00:00

  • Is thenar tissue hemoglobin oxygen saturation in septic shock related to macrohemodynamic variables and outcome?

    abstract:INTRODUCTION:The study objectives were to evaluate septic shock-induced alterations in skeletal muscle hemoglobin oxygenation saturation (StO2) using near-infrared spectroscopy (NIRS) and forearm skin blood flow velocity using laser Doppler (LD) to determine the relationship of macroperfusion and microperfusion paramet...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc8004

    authors: Payen D,Luengo C,Heyer L,Resche-Rigon M,Kerever S,Damoisel C,Losser MR

    更新日期:2009-01-01 00:00:00

  • Year in review 2013: Critical Care--respirology.

    abstract::This review documents important progress made in 2013 in the field of critical care respirology, in particular with regard to acute respiratory failure and acute respiratory distress syndrome. Twenty-five original articles published in the respirology and critical care sections of Critical Care are discussed in the fo...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-014-0577-y

    authors: Curley GF,Slutsky AS

    更新日期:2014-10-15 00:00:00

  • Impact of whole-body computed tomography on mortality and surgical management of severe blunt trauma.

    abstract:INTRODUCTION:The mortality benefit of whole-body computed tomography (CT) in early trauma management remains controversial and poorly understood. The objective of this study was to assess the impact of whole-body CT compared with selective CT on mortality and management of patients with severe blunt trauma. METHODS:Th...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc11375

    authors: Yeguiayan JM,Yap A,Freysz M,Garrigue D,Jacquot C,Martin C,Binquet C,Riou B,Bonithon-Kopp C,FIRST Study Group.

    更新日期:2012-06-11 00:00:00

  • N-acetylcysteine decreases lactate signal intensities in liver tissue and improves liver function in septic shock patients, as shown by magnetic resonance spectroscopy: extended case report.

    abstract:BACKGROUND:N-acetylcysteine (NAC) has been shown to improve splanchnic blood flow in experimental studies. This report evaluates the effects of NAC on liver perfusion and lactate signal intensities in the liver tissue of septic shock patients using proton magnetic resonance imaging and spectroscopy. Furthermore, the mo...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc2426

    authors: Hein OV,Ohring R,Schilling A,Oellerich M,Armstrong VW,Kox WJ,Spies C

    更新日期:2004-04-01 00:00:00

  • Changes in sedation management in German intensive care units between 2002 and 2006: a national follow-up survey.

    abstract:BACKGROUND:The aim of this study, conducted in 2006, was to find out whether changes in sedation management in German intensive care units took place in comparison with our survey from 2002. METHODS:We conducted a follow-up survey with a descriptive and comparative cross-sectional multi-center design. A postal survey ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc6189

    authors: Martin J,Franck M,Sigel S,Weiss M,Spies C

    更新日期:2007-01-01 00:00:00

  • The gray zone of the qualitative assessment of respiratory changes in inferior vena cava diameter in ICU patients.

    abstract:INTRODUCTION:Transthoracic echocardiography (TTE) is a useful tool for minimally invasive hemodynamic monitoring in the ICU. Dynamic indices (such as the inferior vena cava distensibility index (dIVC)) can be used to predict fluid responsiveness in mechanically ventilated patients. Although quantitative use of the dIVC...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13693

    authors: Duwat A,Zogheib E,Guinot P,Levy F,Trojette F,Diouf M,Slama M,Dupont H

    更新日期:2014-01-14 00:00:00

  • Comparison of sufentanil with sufentanil plus magnesium sulphate for sedation in the intensive care unit using bispectral index.

    abstract:INTRODUCTION:In intensive care unit patients we assessed, using bispectral index (BIS) monitoring, whether the addition of magnesium sulphate infusion could decrease the sufentanil infusion required to maintain sedation. PATIENTS AND METHODS:A total of 30 adult patients who were expected to require mechanical ventilat...

    journal_title:Critical care (London, England)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1186/cc2365

    authors: Memiş D,Turan A,Karamanlioglu B,Oguzhan N,Pamukçu Z

    更新日期:2003-10-01 00:00:00

  • Blood glucose measurements in the critically ill: more than just a blood draw.

    abstract::A crucial determinant for the success of intensive insulin therapy in critically ill patients is the frequent and accurate measurement of blood glucose values with immediate feedback of results. In general, therefore, this is achieved by point-of-care testing, raising the question of the best way of monitoring blood g...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc5110

    authors: Brunkhorst FM,Wahl HG

    更新日期:2006-01-01 00:00:00

  • Impact of post-traumatic stress symptoms on the health-related quality of life in a cohort study with chronically critically ill patients and their partners: age matters.

    abstract:BACKGROUND:Survivors of an acute critical illness with continuing organ dysfunction and uncontrolled inflammatory responses are prone to become chronically critically ill. As mental sequelae, a post-traumatic stress disorder and an associated decrease in the health-related quality of life (QoL) may occur, not only in t...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2321-0

    authors: Wintermann GB,Petrowski K,Weidner K,Strauß B,Rosendahl J

    更新日期:2019-02-08 00:00:00

  • Intraoperative renal near-infrared spectroscopy indicates developing acute kidney injury in infants undergoing cardiac surgery with cardiopulmonary bypass: a case-control study.

    abstract:INTRODUCTION:Acute kidney injury (AKI) is a frequent complication after cardiac surgery with cardiopulmonary bypass in infants. Renal near-infrared spectroscopy (NIRS) is used to evaluate regional oximetry in a non-invasive continuous real-time fashion, and reflects tissue perfusion. The aim of this study was to evalua...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-0760-9

    authors: Ruf B,Bonelli V,Balling G,Hörer J,Nagdyman N,Braun SL,Ewert P,Reiter K

    更新日期:2015-01-29 00:00:00

  • The administration of dextrose during in-hospital cardiac arrest is associated with increased mortality and neurologic morbidity.

    abstract:INTRODUCTION:Dextrose may be used during cardiac arrest resuscitation to prevent or reverse hypoglycemia. However, the incidence of dextrose administration during cardiac arrest and the association of dextrose administration with survival and other outcomes are unknown. METHODS:We used the Get With The Guidelines®-Res...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-0867-z

    authors: Peng TJ,Andersen LW,Saindon BZ,Giberson TA,Kim WY,Berg K,Novack V,Donnino MW,American Heart Association’s Get With The Guidelines®-Resuscitation Investigators.

    更新日期:2015-04-10 00:00:00

  • Biomarkers of lung epithelial injury and inflammation distinguish severe sepsis patients with acute respiratory distress syndrome.

    abstract:INTRODUCTION:Despite recent modifications, the clinical definition of the acute respiratory distress syndrome (ARDS) remains non-specific, leading to under-diagnosis and under-treatment. This study was designed to test the hypothesis that a biomarker panel would be useful for biologic confirmation of the clinical diagn...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13080

    authors: Ware LB,Koyama T,Zhao Z,Janz DR,Wickersham N,Bernard GR,May AK,Calfee CS,Matthay MA

    更新日期:2013-10-24 00:00:00

  • Bench-to-bedside review: fulfilling promises of the Human Genome Project.

    abstract::Since most common diseases have been shown to be influenced by inherited variations in our genes, completion of the Human Genome Project and mapping of the human genome single-nucleotide polymorphisms will have a tremendous impact on our approach to medicine. New developments in genotyping techniques and bioinformatic...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc1491

    authors: Chiche JD,Cariou A,Mira JP

    更新日期:2002-06-01 00:00:00

  • Endothelial dysfunction is a potential contributor to multiple organ failure and mortality in aged mice subjected to septic shock: preclinical studies in a murine model of cecal ligation and puncture.

    abstract:INTRODUCTION:The goal of the current study was to investigate the effect of aging on the development of endothelial dysfunction in a murine model of sepsis, and to compare it with the effect of genetic deficiency of the endothelial isoform of nitric oxide synthase (eNOS). METHODS:Cecal ligation and puncture (CLP) was ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-014-0511-3

    authors: Coletta C,Módis K,Oláh G,Brunyánszki A,Herzig DS,Sherwood ER,Ungvári Z,Szabo C

    更新日期:2014-09-16 00:00:00

  • Serum neutrophil gelatinase-associated lipocalin at inception of renal replacement therapy predicts survival in critically ill patients with acute kidney injury.

    abstract:INTRODUCTION:Neutrophil gelatinase-associated lipocalin (NGAL) is a promising novel biomarker that correlates with the severity and outcome of acute kidney injury (AKI). However, its prognostic utility during the late course of AKI, especially in patients that require renal replacement therapy (RRT) remains unknown. Th...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc8861

    authors: Kümpers P,Hafer C,Lukasz A,Lichtinghagen R,Brand K,Fliser D,Faulhaber-Walter R,Kielstein JT

    更新日期:2010-01-01 00:00:00

  • Central venous pressure measurement is associated with improved outcomes in septic patients: an analysis of the MIMIC-III database.

    abstract:PURPOSE:Measurement of central venous pressure (CVP) can be a useful clinical tool. However, the formal utility of CVP measurement in preventing mortality in septic patients has never been proven. METHODS:The Medical Information Mart for Intensive Care III (MIMIC-III) database was searched to identify septic patients ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03109-9

    authors: Chen H,Zhu Z,Zhao C,Guo Y,Chen D,Wei Y,Jin J

    更新日期:2020-07-14 00:00:00

  • Prevalence of iron deficiency on ICU discharge and its relation with fatigue: a multicenter prospective study.

    abstract:INTRODUCTION:Prevalence of iron deficiency (ID) at intensive care (ICU) admission is around 25 to 40%. Blood losses are important during ICU stay, leading to iron losses, but prevalence of ID at ICU discharge is unknown. ID has been associated with fatigue and muscular weakness, and may thus impair post-ICU rehabilitat...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-014-0542-9

    authors: Lasocki S,Chudeau N,Papet T,Tartiere D,Roquilly A,Carlier L,Mimoz O,Seguin P,Malledant Y,Asehnoune K,Hamel JF,AtlanREA group.

    更新日期:2014-09-30 00:00:00

  • Early postoperative serum S100 beta levels predict ongoing brain damage after meningioma surgery: a prospective observational study.

    abstract:INTRODUCTION:Elevated serum levels of S100beta, an astrocyte-derived protein, correlate with unfavourable neurological outcomes following cardiac surgery, neurotrauma, and resuscitation. This study evaluated whether pre-/postoperative serum S100beta levels correlate with unfavourable clinical and radiological findings ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc5058

    authors: Einav S,Shoshan Y,Ovadia H,Matot I,Hersch M,Itshayek E

    更新日期:2006-01-01 00:00:00

  • A meta-analysis of the resuscitative effects of mechanical and manual chest compression in out-of-hospital cardiac arrest patients.

    abstract:OBJECTIVES:To evaluate the resuscitative effects of mechanical and manual chest compression in patients with out-of-hospital cardiac arrest (OHCA). METHODS:All randomized controlled and cohort studies comparing the effects of mechanical compression and manual compression on cardiopulmonary resuscitation in OHCA patien...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析

    doi:10.1186/s13054-019-2389-6

    authors: Zhu N,Chen Q,Jiang Z,Liao F,Kou B,Tang H,Zhou M

    更新日期:2019-03-27 00:00:00

  • Adipose tissue protects against sepsis-induced muscle weakness in mice: from lipolysis to ketones.

    abstract:BACKGROUND:ICU-acquired weakness is a debilitating consequence of prolonged critical illness that is associated with poor outcome. Recently, premorbid obesity has been shown to protect against such illness-induced muscle wasting and weakness. Here, we hypothesized that this protection was due to increased lipid and ket...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2506-6

    authors: Goossens C,Weckx R,Derde S,Dufour T,Vander Perre S,Pauwels L,Thiessen SE,Van Veldhoven PP,Van den Berghe G,Langouche L

    更新日期:2019-07-01 00:00:00

  • Circulating cytokines in predicting development of severe acute pancreatitis.

    abstract::Acute pancreatitis is an inflammatory disease process which may present with clinical manifestations ranging from benign self-limited disease to overwhelming sepsis. The ability to predict outcome would be helpful in developing treatment plans, and possibly in stratifying patients for clinical trials. ...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/s13054-014-0575-0

    authors: Rotstein OD

    更新日期:2014-10-20 00:00:00