tailieunhanh - Báo cáo khoa học: " Predicting a low cortisol response to adrenocorticotrophic hormone in the critically ill: 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: Predicting a low cortisol response to adrenocorticotrophic hormone in the critically ill: a retrospective cohort study. | Available online http content 11 3 R61 Research Predicting a low cortisol response to adrenocorticotrophic hormone in the critically ill a retrospective cohort study Margriet FC de Jong1 Albertus Beishuizen1 Jan-Jaap Spijkstra1 Armand RJ Girbes1 Rob JM Strack van Schijndel1 Jos WR Twisk2 and AB Johan Groeneveld1 Department of Intensive Care Institute for Cardiovascular Research Vrije Universiteit Medical Center De Boelelaan 1081 HV Amsterdam The Netherlands 2Department of Epidemiology and Biostatistics Institute for Cardiovascular Research Vrije Universiteit Medical Center De Boelelaan 1081 HV Amsterdam The Netherlands Corresponding author AB Johan Groeneveld Received 3 Apr 2007 Revisions requested 21 Apr 2007 Revisions received 30 Apr 2007 Accepted 24 May 2007 Published 24 May 2007 Critical Care 2007 11 R61 doi cc5928 This article is online at http content 11 3 R61 2007 de Jong 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 Identification of risk factors for diminished cortisol response to adrenocorticotrophic hormone ACTH in the critically ill could facilitate recognition of relative adrenal insufficiency in these patients. Therefore we studied predictors of a low cortisol response to ACTH. Methods A retrospective cohort study was conducted in a general intensive care unit of a university hospital over a three year period. The study included 405 critically ill patients who underwent a 250 pg ACTH stimulation test because of prolonged hypotension or need for vasopressor inotropic therapy. Plasma cortisol was measured before and 30 and 60 min after ACTH injection. A low adrenal response was defined as an increase in cortisol .