Beta-endorphin, cortisol and postoperative delirium: a preliminary report
A transient delirium, including hallucinations and disorientation, occurred at some time during a 48 to 72 hr postoperative period in patients recovering from elective surgery in an intensive care unit. The occurrence of delirium in these patients was associated with a significant and unusually prol...
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| Veröffentlicht in: | Psychoneuroendocrinology 1985, Vol.10 (3), p.303-313 |
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| container_title | Psychoneuroendocrinology |
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| creator | McIntosh, Tracy K. Bush, Harry L. Yeston, Neil S. Grasberger, Robert Palter, Marc Aun, Frederico Egdahl, Richard H. |
| description | A transient delirium, including hallucinations and disorientation, occurred at some time during a 48 to 72 hr postoperative period in patients recovering from elective surgery in an intensive care unit. The occurrence of delirium in these patients was associated with a significant and unusually prolonged postoperative increase in circulating levels of beta-endorphin (B-endorphin) and cortisol, and a total disruption of normal plasma circadian rhythms of B-endorphin and cortisol. Postoperative mean 24-hr plasma levels of B-endorphin and cortisol were not significantly different from preoperative baseline levels in those patients who did not exhibit post-surgical delirium. Circadian rhythms of B-endorphin and cortisol in the non-delirious patients also remained normal following surgery, although peak plasma concentrations were significantly phase-shifted to later in the day. A disruption in circadian rhythms of the endogenous opiate/hypothalamic - pituitary - adrenal axis may represent an important component of post-operative psychological changes that are frequently observed in the intensive care unit setting. |
| doi_str_mv | 10.1016/0306-4530(85)90007-1 |
| format | Article |
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The occurrence of delirium in these patients was associated with a significant and unusually prolonged postoperative increase in circulating levels of beta-endorphin (B-endorphin) and cortisol, and a total disruption of normal plasma circadian rhythms of B-endorphin and cortisol. Postoperative mean 24-hr plasma levels of B-endorphin and cortisol were not significantly different from preoperative baseline levels in those patients who did not exhibit post-surgical delirium. Circadian rhythms of B-endorphin and cortisol in the non-delirious patients also remained normal following surgery, although peak plasma concentrations were significantly phase-shifted to later in the day. A disruption in circadian rhythms of the endogenous opiate/hypothalamic - pituitary - adrenal axis may represent an important component of post-operative psychological changes that are frequently observed in the intensive care unit setting.</description><identifier>ISSN: 0306-4530</identifier><identifier>EISSN: 1873-3360</identifier><identifier>DOI: 10.1016/0306-4530(85)90007-1</identifier><identifier>PMID: 2932761</identifier><identifier>CODEN: PSYCDE</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adult ; Aged ; beta-Endorphin ; Biological and medical sciences ; Circadian Rhythm ; Delirium - blood ; Delirium - etiology ; Delirium - physiopathology ; Endorphins - blood ; Humans ; Hydrocortisone - blood ; Hypothalamo-Hypophyseal System - physiopathology ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Pituitary-Adrenal System - physiopathology ; Postoperative Complications - blood ; Postoperative Complications - etiology ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Techniques and methods</subject><ispartof>Psychoneuroendocrinology, 1985, Vol.10 (3), p.303-313</ispartof><rights>1985</rights><rights>1986 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c452t-a0ebddf4be9fcf51090e43c267a3cf5550c44b3696f49ff306eb3ca7d8bf62e33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0306-4530(85)90007-1$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8754879$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2932761$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McIntosh, Tracy K.</creatorcontrib><creatorcontrib>Bush, Harry L.</creatorcontrib><creatorcontrib>Yeston, Neil S.</creatorcontrib><creatorcontrib>Grasberger, Robert</creatorcontrib><creatorcontrib>Palter, Marc</creatorcontrib><creatorcontrib>Aun, Frederico</creatorcontrib><creatorcontrib>Egdahl, Richard H.</creatorcontrib><title>Beta-endorphin, cortisol and postoperative delirium: a preliminary report</title><title>Psychoneuroendocrinology</title><addtitle>Psychoneuroendocrinology</addtitle><description>A transient delirium, including hallucinations and disorientation, occurred at some time during a 48 to 72 hr postoperative period in patients recovering from elective surgery in an intensive care unit. The occurrence of delirium in these patients was associated with a significant and unusually prolonged postoperative increase in circulating levels of beta-endorphin (B-endorphin) and cortisol, and a total disruption of normal plasma circadian rhythms of B-endorphin and cortisol. Postoperative mean 24-hr plasma levels of B-endorphin and cortisol were not significantly different from preoperative baseline levels in those patients who did not exhibit post-surgical delirium. Circadian rhythms of B-endorphin and cortisol in the non-delirious patients also remained normal following surgery, although peak plasma concentrations were significantly phase-shifted to later in the day. A disruption in circadian rhythms of the endogenous opiate/hypothalamic - pituitary - adrenal axis may represent an important component of post-operative psychological changes that are frequently observed in the intensive care unit setting.</description><subject>Adult</subject><subject>Aged</subject><subject>beta-Endorphin</subject><subject>Biological and medical sciences</subject><subject>Circadian Rhythm</subject><subject>Delirium - blood</subject><subject>Delirium - etiology</subject><subject>Delirium - physiopathology</subject><subject>Endorphins - blood</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Hypothalamo-Hypophyseal System - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Pituitary-Adrenal System - physiopathology</subject><subject>Postoperative Complications - blood</subject><subject>Postoperative Complications - etiology</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Techniques and methods</subject><issn>0306-4530</issn><issn>1873-3360</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1985</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMo67r6DxR6EFGwmjRp2noQdPFjYcGLnkOaTDDSNjVpF_z3Zt1lj56GYZ53mHkQOiX4hmDCbzHFPGU5xZdlflVhjIuU7KEpKQuaUsrxPprukEN0FMJXZHjJswmaZBXNCk6maPEIg0yh0873n7a7TpTzgw2uSWSnk96FwfXg5WBXkGhorLdje5fIpPexaW0n_U_ioY-hY3RgZBPgZFtn6OP56X3-mi7fXhbzh2WqWJ4NqcRQa21YDZVRJie4wsCoynghaezzHCvGasorblhlTHwAaqpkocva8AwonaGLzd7eu-8RwiBaGxQ0jezAjUEUnLGSZVkE2QZU3oXgwYje2zYeLAgWa4NirUes9YgyF38GBYmxs-3-sW5B70JbZXF-vp3LoGRjvOyUDTusLHJWFlXE7jcYRBcrC14EZaFToK0HNQjt7P93_AIdW41X</recordid><startdate>1985</startdate><enddate>1985</enddate><creator>McIntosh, Tracy K.</creator><creator>Bush, Harry L.</creator><creator>Yeston, Neil S.</creator><creator>Grasberger, Robert</creator><creator>Palter, Marc</creator><creator>Aun, Frederico</creator><creator>Egdahl, Richard H.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1985</creationdate><title>Beta-endorphin, cortisol and postoperative delirium: a preliminary report</title><author>McIntosh, Tracy K. ; Bush, Harry L. ; Yeston, Neil S. ; Grasberger, Robert ; Palter, Marc ; Aun, Frederico ; Egdahl, Richard H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c452t-a0ebddf4be9fcf51090e43c267a3cf5550c44b3696f49ff306eb3ca7d8bf62e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1985</creationdate><topic>Adult</topic><topic>Aged</topic><topic>beta-Endorphin</topic><topic>Biological and medical sciences</topic><topic>Circadian Rhythm</topic><topic>Delirium - blood</topic><topic>Delirium - etiology</topic><topic>Delirium - physiopathology</topic><topic>Endorphins - blood</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Hypothalamo-Hypophyseal System - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Pituitary-Adrenal System - physiopathology</topic><topic>Postoperative Complications - blood</topic><topic>Postoperative Complications - etiology</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Techniques and methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McIntosh, Tracy K.</creatorcontrib><creatorcontrib>Bush, Harry L.</creatorcontrib><creatorcontrib>Yeston, Neil S.</creatorcontrib><creatorcontrib>Grasberger, Robert</creatorcontrib><creatorcontrib>Palter, Marc</creatorcontrib><creatorcontrib>Aun, Frederico</creatorcontrib><creatorcontrib>Egdahl, Richard H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Psychoneuroendocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McIntosh, Tracy K.</au><au>Bush, Harry L.</au><au>Yeston, Neil S.</au><au>Grasberger, Robert</au><au>Palter, Marc</au><au>Aun, Frederico</au><au>Egdahl, Richard H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Beta-endorphin, cortisol and postoperative delirium: a preliminary report</atitle><jtitle>Psychoneuroendocrinology</jtitle><addtitle>Psychoneuroendocrinology</addtitle><date>1985</date><risdate>1985</risdate><volume>10</volume><issue>3</issue><spage>303</spage><epage>313</epage><pages>303-313</pages><issn>0306-4530</issn><eissn>1873-3360</eissn><coden>PSYCDE</coden><abstract>A transient delirium, including hallucinations and disorientation, occurred at some time during a 48 to 72 hr postoperative period in patients recovering from elective surgery in an intensive care unit. The occurrence of delirium in these patients was associated with a significant and unusually prolonged postoperative increase in circulating levels of beta-endorphin (B-endorphin) and cortisol, and a total disruption of normal plasma circadian rhythms of B-endorphin and cortisol. Postoperative mean 24-hr plasma levels of B-endorphin and cortisol were not significantly different from preoperative baseline levels in those patients who did not exhibit post-surgical delirium. Circadian rhythms of B-endorphin and cortisol in the non-delirious patients also remained normal following surgery, although peak plasma concentrations were significantly phase-shifted to later in the day. A disruption in circadian rhythms of the endogenous opiate/hypothalamic - pituitary - adrenal axis may represent an important component of post-operative psychological changes that are frequently observed in the intensive care unit setting.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>2932761</pmid><doi>10.1016/0306-4530(85)90007-1</doi><tpages>11</tpages></addata></record> |
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| subjects | Adult Aged beta-Endorphin Biological and medical sciences Circadian Rhythm Delirium - blood Delirium - etiology Delirium - physiopathology Endorphins - blood Humans Hydrocortisone - blood Hypothalamo-Hypophyseal System - physiopathology Male Medical sciences Middle Aged Miscellaneous Pituitary-Adrenal System - physiopathology Postoperative Complications - blood Postoperative Complications - etiology Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Techniques and methods |
| title | Beta-endorphin, cortisol and postoperative delirium: a preliminary report |
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