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Determination of salivary cortisol to assess time-related changes of the adrenal response to stress in critically ill patients.

Abstract：

BACKGROUND:The value of salivary cortisol measurement to study stress-related adrenal response is controversial. The study aim was to assess the role of salivary cortisol measurement to detect time-related changes of adrenal response in critically ill patients. PATIENTS AND METHODS:Patients with organ failure, sepsis or trauma were prospectively recruited in the Emergency Department. Serum and salivary cortisol were measured at baseline (T0) and after 48 h (T48). In 33 patients ACTH test was also done. RESULTS:Fifty-five patients were studied and classified as septic (22) or non-septic (33). We found a significant correlation between serum and salivary cortisol at T0 and T48. No patient had baseline serum cortisol < 276 nmol/L and salivary cortisol significantly decreased at T48 in almost all patients. A delta serum cortisol < 250 nmol/L after ACTH was found in only 4 patients who showed elevated baseline cortisol levels. CONCLUSION:We found that reduced baseline and post-ACTH cortisol levels are uncommon in our samples. In patients able to provide adequate saliva samples, salivary cortisol may be used to check the degree of stress-induced response and appears as a suitable tool for multiple measurements over time.

journal_name

Eur J Intern Med

journal_title

European journal of internal medicine

authors

Puglisi S,Pizzuto A,Laface B,Panero F,Aprà F,Palmas E,Perotti P,Reimondo G,Boccuzzi A,Terzolo M

doi

10.1016/j.ejim.2019.08.001

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

66-70

eissn

0953-6205

issn

1879-0828

pii

S0953-6205(19)30272-9

journal_volume

68

pub_type

杂志文章

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