tailieunhanh - Báo cáo khoa học: " Adrenal function testing in patients with septic shock"

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: Adrenal function testing in patients with septic shock. | Available online http content 10 5 R149 Research Adrenal function testing in patients with septic shock Diamantino Ribeiro Salgado1 Juan Carlos Rosso Verdeal1 and José Rodolfo Rocco2 Intensive Care Unit Barra Dor Hospital Avenida Ayrton Senna 2541 Barra da Tijuca Rio de Janeiro CEP 22775-001 Brazil intensive Care Unit Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil Corresponding author Diamantino Ribeiro Salgado Received 27 Jul 2006 Revisions requested 21 Aug 2006 Revisions received 22 Sep 2006 Accepted 25 Oct 2006 Published 25 Oct 2006 Critical Care 2006 10 R149 doi cc5077 This article is online at http content 10 5 R149 2006 Salgado et al. licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Open Access Abstract Introduction Adrenal failure AF is associated with increased mortality in septic patients. Nonetheless there is no agreement regarding the best diagnostic criteria for AF. We compared the diagnosis of AF considering different baseline total cortisol cutoff values and Amax values after low 1 pg and high 249 pg doses of corticotropin we analyzed the impact of serum albumin on AF identification and we correlated laboratorial AF with norepinephrine removal. Methods A prospective noninterventional study was performed in an intensive care unit from May 2002 to May 2005 including septic shock patients over 18 years old without previous steroid usage. After measurement of serum albumin and baseline total cortisol the patients were sequentially submitted to 1 pg and 249 pg corticotropin tests with a 60-minute interval between doses. Post-stimuli cortisol levels were drawn 60 minutes after each test cortisol 60 and cortisol