ArticleIntensive care medicine2007
Relative adrenal insufficiency in patients with severe acute pancreatitis.
Article in Intensive care medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Corticosteroid treatment for acute/acute-on-chronic experimental and naturally occurring pancreatitis in several species: a scoping review to inform possible use in dogs.Acta veterinaria Scandinavica · 2021Article
- Critical Illness-Related Corticosteroid Insufficiency in Patients with Low Cardiac Output Syndrome after Cardiac Surgery.The Korean journal of thoracic and cardiovascular surgery · 2018Article
- Addison's Disease Mimicking as Acute Pancreatitis: A Case Report.Journal of clinical and diagnostic research : JCDR · 2017Article
- Poly(ADP-ribose) polymerase inhibition suppresses inflammation and promotes recovery from adrenal injury in a rat model of acute necrotizing pancreatitis.BMC gastroenterology · 2016Article
- New Roles for Corticosteroid Binding Globulin and Opposite Expression Profiles in Lung and Liver.PloS one · 2016Article
- Glucocorticoid Receptor Expression in Peripheral WBCs of Critically Ill Children.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2015Article
- Changes of inflammation and apoptosis in adrenal gland after experimental injury in rats with acute necrotizing pancreatitis.Inflammation · 2012Article
- Serum cytokines and critical illness-related corticosteroid insufficiency.Intensive care medicine · 2010Article
- [Corticosteroid insufficiency in the critically ill. Pathomechanisms and recommendations for diagnosis and treatment].Der Anaesthesist · 2009Review
- The adrenocorticotropic hormone-induced cortisol response in acute pancreatitis.Critical care (London, England) · 2009Article
- Critical illness-related corticosteroid insufficiency in patients with severe acute biliary pancreatitis: a prospective cohort study.Critical care (London, England) · 2009Article
- Year in review in Intensive Care Medicine, 2007. I. Experimental studies. Clinical studies: brain injury and neurology, renal failure and endocrinology.Intensive care medicine · 2008Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveInadequate cortisol levels and adrenal dysfunction may play a role in the pathophysiology of severe acute pancreatitis. This study aimed to analyse the incidence of relative adrenal insufficiency (RAI) in these patients, to identify factors associated with RAI and to describe how adrenal responsiveness affects outcome.
designProspective observational multicenter study. PATIENTS: Twenty-five patients with severe acute pancreatitis.
interventionsA short Synacthen test (SST) was performed within 5 days after admission to the hospital. The incidence of RAI, defined as an increment after SST of less than 9 microg/dl was the primary endpoint of the study. Serum cortisol was measured at baseline and at 30 and 60 min after administration of 250 microg adrenocorticotropic hormone. MEASUREMENTS AND
resultsMedian baseline cortisol level was 26.6 microg/dl, and increased to 43.2 microg/dl and 48.8 microg/dl after 30 min and 60 min respectively. RAI was found in 16% of all patients and in 27% of patients with organ dysfunction. Patients with RAI were more severely ill and had higher SOFA scores from days 4 to 7 after admission. All patients with RAI developed pancreatic necrosis, and all of them needed surgical intervention. Twenty-eight-day mortality was significantly higher in patients with RAI (75% vs. 5%, p =0.007). Patients who died had a lower increment in cortisol levels after the SST than patients who survived.
conclusionRAI is frequent in patients with severe acute pancreatitis and organ dysfunction. It occurs in patients with more severe pancreatitis and is associated with increased mortality.
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