TY - JOUR
T1 - Endocrine alterations in critically iii patients with stroke during the early recovery period
AU - Dimopoulou, Ioanna
AU - Kouyialis, Andreas T.
AU - Orfanos, Stylianos
AU - Armaganidis, Apostolos
AU - Tzanela, Marinella
AU - Thalassinos, Nikolaos
AU - Tsagarakis, Stylianos
PY - 2005/12
Y1 - 2005/12
N2 - 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.
AB - 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.
KW - Cortisol hyporesponsiveness
KW - Growth hormone deficiency
KW - Hypogonadism
KW - Intracerebral hemorrhage
KW - Ischemic stroke
KW - Mechanical ventilation
KW - Thyroid dysfunction
UR - http://www.scopus.com/inward/record.url?scp=29344432454&partnerID=8YFLogxK
U2 - 10.1385/NCC:3:3:224
DO - 10.1385/NCC:3:3:224
M3 - Article
C2 - 16377833
AN - SCOPUS:29344432454
SN - 1541-6933
VL - 3
SP - 224
EP - 229
JO - Neurocritical Care
JF - Neurocritical Care
IS - 3
ER -