Clinical evaluation of hormonal stress state in medical ICU patients: a prospective blinded observational study.

Détails

ID Serval
serval:BIB_C09518B1FCA7
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Clinical evaluation of hormonal stress state in medical ICU patients: a prospective blinded observational study.
Périodique
Intensive Care Medicine
Auteur(s)
Kyle U.G., Jolliet P., Genton L., Meier C.A., Mensi N., Graf J.D., Chevrolet J.C., Pichard C.
ISSN
0342-4642 (Print)
ISSN-L
0342-4642
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
31
Numéro
12
Pages
1669-1675
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
OBJECTIVE: To evaluate whether classification of patients as having low, moderate, or high stress based on clinical parameters is associated with plasma levels of stress hormone.
DESIGN AND SETTING: Prospective, blinded, observational study in an 18-bed medical ICU.
PATIENTS: Eighty-eight consecutive patients.
INTERVENTIONS: Patients were classified as low (n=28), moderate (n=33) or high stress (n=27) on days 0 and 3 of ICU stay, based on 1 point for each abnormal parameter: body temperature, heart rate, systemic arterial pressure, respiratory rate, physical agitation, presence of infection and catecholamine administration. The stress categories were: high: 4 points or more, moderate 2-3 points, low 1 point. Plasma growth hormone (GH), insulin-like growth factor 1 (IGF-1), insulin, glucagon, cortisol were measured on days 0 and 3.
MEASUREMENTS AND RESULTS: Plasma cortisol and glucagon were significantly higher and IGF-1 lower in high vs. low stress patients on days 0 and 3. High stress patients were more likely to have high cortisol levels (odds ratio 5.8, confidence interval 1.8-18.9), high glucagon (8.7, 2.1-36.1), and low IGF-1 levels (5.9, 1.8-19.0) than low stress patients on day 0. Moderate stress patients were also more likely to have high cortisol and glucagon levels than low stress patients. Insulin and GH did not differ significantly. Results were similar for day 3.
CONCLUSIONS: Moderate and severe stress was significantly associated with high catabolic (cortisol, glucagon) and low anabolic (IGF-1) hormone levels. The hormonal stress level in ICU patients can be estimated from simple clinical parameters during routine clinical evaluation.
Mots-clé
Adolescent, Adult, Aged, Aged, 80 and over, Critical Illness, Female, Glucagon/blood, Growth Hormone/blood, Hormones/blood, Humans, Hydrocortisone/blood, Insulin/blood, Logistic Models, Male, Middle Aged, Pilot Projects, Prospective Studies, Single-Blind Method, Somatomedins/metabolism, Statistics, Nonparametric, Stress, Physiological/blood, Stress, Physiological/classification
Pubmed
Web of science
Création de la notice
27/06/2013 15:29
Dernière modification de la notice
03/03/2018 21:06
Données d'usage