Endocrine alterations in critically iii patients with stroke during the early recovery period

Ioanna Dimopoulou, Andreas T. Kouyialis, Stylianos Orfanos, Apostolos Armaganidis, Marinella Tzanela, Nikolaos Thalassinos, Stylianos Tsagarakis

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Endocrine abnormalities in critically ill patients with stroke during the early recovery period have not been well characterized. Methods: To investigate this issue, 33 consecutive mechanically ventilated patients (27 men) with hemorrhagic (n = 21) or ischemic (n = 12) stroke having a mean age of 57 ± 12 years were studied. Glasgow Coma Scale score on admission in the hospital was 8 ± 3. The following basal hormones were measured within 72 hours postextubation: cortisol, corticotropin (ACTH), free thyroxine, tri-iodothyronine, thyroid-stimulating hormone, testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, growth hormone, and insulin-like growth factor (IGF)-1. Subsequently, a low-dose (1 μg) ACTH stimulation test was performed. Results: Twenty-six (79%) patients showed endocrine alterations. The most common change was low IGF-1 levels compatible with growth hormone deficiency (45%), followed by hypogonadism (39%), thyroid dysfunction (36%), and cortisol hyporesponsiveness (33%). Conclusion: Neuroendocrine changes occur with high frequency in critically ill patients with stroke during the early recovery period. It remains to be determined whether these changes have implications for functional and/or clinical outcome.

Original languageEnglish
Pages (from-to)224-229
Number of pages6
JournalNeurocritical Care
Volume3
Issue number3
DOIs
Publication statusPublished - Dec 2005

Keywords

  • Cortisol hyporesponsiveness
  • Growth hormone deficiency
  • Hypogonadism
  • Intracerebral hemorrhage
  • Ischemic stroke
  • Mechanical ventilation
  • Thyroid dysfunction

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