tailieunhanh - Báo cáo y học: "Hormonal responses upon return of spontaneous circulation after cardiac arrest: a retrospective cohort study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Hormonal responses upon return of spontaneous circulation after cardiac arrest: a retrospective cohort study. | Kim et al. Critical Care 2011 15 R53 http content 15 1 R53 KS CRITICAL CARE RESEARCH Open Access Hormonal responses upon return of spontaneous circulation after cardiac arrest a retrospective cohort study 1 2 3 1 4 1 Jin Joo Kim Sung Youl Hyun Seong Youn Hwang Young Bo Jung Jong Hwan Shin Yong Su Lim Jin Seong Cho1 Hyuk Jun Yang1 Gun Lee1 Abstract Introduction Cardiac arrest is often fatal and can be extremely stressful to patients even if spontaneous rhythm is returned. The purpose of this study was to analyze the hormonal response after return of spontaneous circulation ROSC . Methods This is a retrospective review of the chart and laboratory findings in a single medical facility. The patients admitted to the intensive care unit after successful resuscitation after out-of-hospital cardiac arrest were retrospectively identified and evaluated. Patients with hormonal diseases patients who received cortisol treatment those experiencing trauma and pregnant women were excluded. Serum cortisol adrenocorticotropic hormone ACTH and anti-diuretic hormone ADH vasopressin were analyzed and a corticotropin-stimulation test was performed. Mortality at one week and one month after admission and neurologic outcome cerebral performance category CPC one month after admission were evaluated. Results A total of 117 patients including 84 males were evaluated in this study. One week and one month after admission 87 and 65 patients survived respectively. Relative adrenal insufficiency and higher plasma ACTH and ADH levels were associated with shock-related mortality P and respectively and ACTH and ADH levels were also associated with late mortality P and respectively . Patients with relative adrenal insufficiency ACTH 5 pg mL and ADH 30 pg mL had a two-fold increased risk of a poor outcome shock-related mortality odds ratio OR and 95 confidence interval CI to OR and 95 CI to OR and 95 CI