Adrenal insufficiency in hemorrhagic shock
Adrenal insufficiency during sepsis is well documented. The association between hemorrhagic shock and adrenal insufficiency is unclear and may be related to ischemia, necrosis, or resuscitation. This study was designed to determine the incidence of relative adrenal insufficiency in hemorrhagic shock...
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| Veröffentlicht in: | The American surgeon 2006-06, Vol.72 (6), p.552-554 |
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| creator | RUSHING, G. D BRITT, R. C COLLINS, J. N COLE, F. J WEIRETER, L. J BRITT, L. D |
| description | Adrenal insufficiency during sepsis is well documented. The association between hemorrhagic shock and adrenal insufficiency is unclear and may be related to ischemia, necrosis, or resuscitation. This study was designed to determine the incidence of relative adrenal insufficiency in hemorrhagic shock. A retrospective review of a prospectively gathered database for patients admitted to the trauma intensive care unit with hemorrhagic shock was undertaken. A random serum cortisol of |
| doi_str_mv | 10.1177/000313480607200619 |
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D ; BRITT, R. C ; COLLINS, J. N ; COLE, F. J ; WEIRETER, L. J ; BRITT, L. D</creator><creatorcontrib>RUSHING, G. D ; BRITT, R. C ; COLLINS, J. N ; COLE, F. J ; WEIRETER, L. J ; BRITT, L. D</creatorcontrib><description>Adrenal insufficiency during sepsis is well documented. The association between hemorrhagic shock and adrenal insufficiency is unclear and may be related to ischemia, necrosis, or resuscitation. This study was designed to determine the incidence of relative adrenal insufficiency in hemorrhagic shock. A retrospective review of a prospectively gathered database for patients admitted to the trauma intensive care unit with hemorrhagic shock was undertaken. A random serum cortisol of <25 mcg/dL defined relative adrenal insufficiency. All of the cortisol levels were drawn within the first 24 hours of admission. Data analyzed included demographics, length of stay, injury mechanism, infections, and mortality. Fifteen patients presented with hemorrhagic shock, with 14 of 15 meeting the criteria for relative adrenal insufficiency. The average serum cortisol level was 15.8 (9-26.8). The average APACHE II score was 18.3 (4-33), and the average Injury Severity Score was 22.5 (8-41). The mechanism was blunt trauma in 10 patients and penetrating trauma in 5. The average intensive care unit and hospital length of stay were 13.2 and 27.4 days, respectively. There were five urinary tract infections, four blood stream infections, and two wound infections. Two of the 15 patients died. Relative adrenal insufficiency appears to be common in hemorrhagic shock. Future research is warranted to elucidate the pathophysiology, as well as to prospectively determine which patients may benefit from steroid replacement.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/000313480607200619</identifier><identifier>PMID: 16808213</identifier><identifier>CODEN: AMSUAW</identifier><language>eng</language><publisher>Atlanta, GA: Southeastern Surgical Congress</publisher><subject>Adolescent ; Adrenal glands ; Adrenal Insufficiency - epidemiology ; Adrenals. Adrenal axis. Renin-angiotensin system (diseases) ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Blood pressure ; Child ; Endocrinopathies ; Female ; General aspects ; Hospitals ; Humans ; Hydrocortisone - blood ; Incidence ; Infections ; Intensive care ; Length of Stay ; Male ; Medical sciences ; Medical treatment ; Middle Aged ; Mortality ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Patients ; Regression analysis ; Sample size ; Shock, Hemorrhagic - blood ; Shock, Hemorrhagic - complications ; Shock, Hemorrhagic - mortality ; Survival Rate ; Trauma Severity Indices ; Wounds and Injuries - blood ; Wounds and Injuries - complications ; Wounds and Injuries - mortality</subject><ispartof>The American surgeon, 2006-06, Vol.72 (6), p.552-554</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright The Southeastern Surgical Congress Jun 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-19ea958ca14e7c6a906d3d5fb02bc16a1debdfaac4fcbe39a814574476232bc53</citedby><cites>FETCH-LOGICAL-c402t-19ea958ca14e7c6a906d3d5fb02bc16a1debdfaac4fcbe39a814574476232bc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17847587$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16808213$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>RUSHING, G. D</creatorcontrib><creatorcontrib>BRITT, R. C</creatorcontrib><creatorcontrib>COLLINS, J. N</creatorcontrib><creatorcontrib>COLE, F. J</creatorcontrib><creatorcontrib>WEIRETER, L. J</creatorcontrib><creatorcontrib>BRITT, L. D</creatorcontrib><title>Adrenal insufficiency in hemorrhagic shock</title><title>The American surgeon</title><addtitle>Am Surg</addtitle><description>Adrenal insufficiency during sepsis is well documented. The association between hemorrhagic shock and adrenal insufficiency is unclear and may be related to ischemia, necrosis, or resuscitation. This study was designed to determine the incidence of relative adrenal insufficiency in hemorrhagic shock. A retrospective review of a prospectively gathered database for patients admitted to the trauma intensive care unit with hemorrhagic shock was undertaken. A random serum cortisol of <25 mcg/dL defined relative adrenal insufficiency. All of the cortisol levels were drawn within the first 24 hours of admission. Data analyzed included demographics, length of stay, injury mechanism, infections, and mortality. Fifteen patients presented with hemorrhagic shock, with 14 of 15 meeting the criteria for relative adrenal insufficiency. The average serum cortisol level was 15.8 (9-26.8). The average APACHE II score was 18.3 (4-33), and the average Injury Severity Score was 22.5 (8-41). The mechanism was blunt trauma in 10 patients and penetrating trauma in 5. The average intensive care unit and hospital length of stay were 13.2 and 27.4 days, respectively. There were five urinary tract infections, four blood stream infections, and two wound infections. Two of the 15 patients died. Relative adrenal insufficiency appears to be common in hemorrhagic shock. Future research is warranted to elucidate the pathophysiology, as well as to prospectively determine which patients may benefit from steroid replacement.</description><subject>Adolescent</subject><subject>Adrenal glands</subject><subject>Adrenal Insufficiency - epidemiology</subject><subject>Adrenals. Adrenal axis. Renin-angiotensin system (diseases)</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Blood pressure</subject><subject>Child</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>General aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Incidence</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Sample size</subject><subject>Shock, Hemorrhagic - blood</subject><subject>Shock, Hemorrhagic - complications</subject><subject>Shock, Hemorrhagic - mortality</subject><subject>Survival Rate</subject><subject>Trauma Severity Indices</subject><subject>Wounds and Injuries - blood</subject><subject>Wounds and Injuries - complications</subject><subject>Wounds and Injuries - mortality</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpl0E1Lw0AQBuBFFFurf8CDFEEPQnRnv3MsxS8oeNFzmGx2bWqa1F1z6L93SwMFPQ0DzzswLyGXQO8BtH6glHLgwlBFNaNUQX5ExiClzHLD-DEZ70C2EyNyFuMqrUJJOCUjUIYaBnxM7mZVcC0207qNvfe1rV1rt2mbLt26C2GJn7WdxmVnv87JiccmuothTsjH0-P7_CVbvD2_zmeLzArKfjLIHebSWAThtFWYU1XxSvqSstKCQqhcWXlEK7wtHc_RgJBaCK0YT0LyCbnd392E7rt38adY19G6psHWdX0slJG54oIneP0Hrro-pGdiwYAZUAJYQmyPbOhiDM4Xm1CvMWwLoMWuxuJ_jSl0NVzuy7WrDpGhtwRuBoDRYuMDtraOB6eN0NJo_gv7nXhC</recordid><startdate>20060601</startdate><enddate>20060601</enddate><creator>RUSHING, G. 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Renin-angiotensin system (diseases)</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Blood pressure</topic><topic>Child</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>General aspects</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Incidence</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Sample size</topic><topic>Shock, Hemorrhagic - blood</topic><topic>Shock, Hemorrhagic - complications</topic><topic>Shock, Hemorrhagic - mortality</topic><topic>Survival Rate</topic><topic>Trauma Severity Indices</topic><topic>Wounds and Injuries - blood</topic><topic>Wounds and Injuries - complications</topic><topic>Wounds and Injuries - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>RUSHING, G. D</creatorcontrib><creatorcontrib>BRITT, R. C</creatorcontrib><creatorcontrib>COLLINS, J. N</creatorcontrib><creatorcontrib>COLE, F. J</creatorcontrib><creatorcontrib>WEIRETER, L. J</creatorcontrib><creatorcontrib>BRITT, L. 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D</au><au>BRITT, R. C</au><au>COLLINS, J. N</au><au>COLE, F. J</au><au>WEIRETER, L. J</au><au>BRITT, L. D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adrenal insufficiency in hemorrhagic shock</atitle><jtitle>The American surgeon</jtitle><addtitle>Am Surg</addtitle><date>2006-06-01</date><risdate>2006</risdate><volume>72</volume><issue>6</issue><spage>552</spage><epage>554</epage><pages>552-554</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><coden>AMSUAW</coden><abstract>Adrenal insufficiency during sepsis is well documented. The association between hemorrhagic shock and adrenal insufficiency is unclear and may be related to ischemia, necrosis, or resuscitation. This study was designed to determine the incidence of relative adrenal insufficiency in hemorrhagic shock. A retrospective review of a prospectively gathered database for patients admitted to the trauma intensive care unit with hemorrhagic shock was undertaken. A random serum cortisol of <25 mcg/dL defined relative adrenal insufficiency. All of the cortisol levels were drawn within the first 24 hours of admission. Data analyzed included demographics, length of stay, injury mechanism, infections, and mortality. Fifteen patients presented with hemorrhagic shock, with 14 of 15 meeting the criteria for relative adrenal insufficiency. The average serum cortisol level was 15.8 (9-26.8). The average APACHE II score was 18.3 (4-33), and the average Injury Severity Score was 22.5 (8-41). The mechanism was blunt trauma in 10 patients and penetrating trauma in 5. The average intensive care unit and hospital length of stay were 13.2 and 27.4 days, respectively. There were five urinary tract infections, four blood stream infections, and two wound infections. Two of the 15 patients died. Relative adrenal insufficiency appears to be common in hemorrhagic shock. Future research is warranted to elucidate the pathophysiology, as well as to prospectively determine which patients may benefit from steroid replacement.</abstract><cop>Atlanta, GA</cop><pub>Southeastern Surgical Congress</pub><pmid>16808213</pmid><doi>10.1177/000313480607200619</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adrenal glands Adrenal Insufficiency - epidemiology Adrenals. Adrenal axis. Renin-angiotensin system (diseases) Adult Aged Aged, 80 and over Biological and medical sciences Blood pressure Child Endocrinopathies Female General aspects Hospitals Humans Hydrocortisone - blood Incidence Infections Intensive care Length of Stay Male Medical sciences Medical treatment Middle Aged Mortality Non tumoral diseases. Target tissue resistance. Benign neoplasms Patients Regression analysis Sample size Shock, Hemorrhagic - blood Shock, Hemorrhagic - complications Shock, Hemorrhagic - mortality Survival Rate Trauma Severity Indices Wounds and Injuries - blood Wounds and Injuries - complications Wounds and Injuries - mortality |
| title | Adrenal insufficiency in hemorrhagic shock |
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