Determination of salivary cortisol to assess time-related changes of the adrenal response to stress in critically ill patients |
| |
| Affiliation: | 1. Internal Medicine 1, Department of Clinical and Biological Sciences, University of Turin, Italy;2. Internal Medicine 2 U, A.O.U Citta della Salute e della Scienza, Department of Clinical and Biological Sciences, University of Turin, Italy;3. Emergency Medicine, A.O. San Giovanni Bosco Hospital, Turin, Italy;4. Emergency Medicine, Azienda Sanitaria Universitaria Integrata of Udine, Italy;5. Emergency Medicine, A.O.U San Luigi Hospital, Orbassano (Turin), Italy;1. Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA;2. Amsterdam UMC, University of Amsterdam, Department of General Practice, Amsterdam Cardiovascular Sciences Research Institute, The Netherlands;1. Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada;2. Faculty of pharmacy, Laval University, Québec, Canada;1. Crozer-Chester Medical Center, Upland, PA, USA;2. Deccan College of Medical Sciences, Hyderabad, India;3. Mount Sinai St Luke''s Roosevelt Hospital, New York, USA;4. Westchester Medical Center, New York Medical College, Valhalla, NY, USA;5. Albert Einstein Medical Center, Philadelphia, PA, USA |
| |
| Abstract: | BackgroundThe value of salivary cortisol measurement to study stress-related adrenal response is controversial. The study aim was to assess the role of salivary cortisol measurement to detect time-related changes of adrenal response in critically ill patients.Patients and methodsPatients with organ failure, sepsis or trauma were prospectively recruited in the Emergency Department. Serum and salivary cortisol were measured at baseline (T0) and after 48 h (T48). In 33 patients ACTH test was also done.ResultsFifty-five patients were studied and classified as septic (22) or non-septic (33). We found a significant correlation between serum and salivary cortisol at T0 and T48. No patient had baseline serum cortisol < 276 nmol/L and salivary cortisol significantly decreased at T48 in almost all patients. A delta serum cortisol < 250 nmol/L after ACTH was found in only 4 patients who showed elevated baseline cortisol levels.ConclusionWe found that reduced baseline and post-ACTH cortisol levels are uncommon in our samples. In patients able to provide adequate saliva samples, salivary cortisol may be used to check the degree of stress-induced response and appears as a suitable tool for multiple measurements over time. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
