2006
DOI: 10.1016/j.ajem.2006.02.017
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Relative adrenal insufficiency after cardiac arrest: Impact on postresuscitation disease outcome

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Cited by 43 publications
(30 citation statements)
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“…In the post-cardiac arrest phase, several authors report a relative adrenal insufficiency compared with the metabolic demands of the body. 188,189 Relative adrenal insufficiency in the post-cardiac arrest phase was associated with higher rates of mortality. 188 -190 At present there are no human randomized trials investigating corticosteroid use after ROSC.…”
Section: Steroidsmentioning
confidence: 99%
“…In the post-cardiac arrest phase, several authors report a relative adrenal insufficiency compared with the metabolic demands of the body. 188,189 Relative adrenal insufficiency in the post-cardiac arrest phase was associated with higher rates of mortality. 188 -190 At present there are no human randomized trials investigating corticosteroid use after ROSC.…”
Section: Steroidsmentioning
confidence: 99%
“…In the current study, the hormonal concentrations were measured on the first morning after ICU admission (12 to 24 hours after ROSC). The optimal timing for obtaining the basal and post-stimulation serum cortisol concentrations was recommended at that time, and this was helpful in estimating a prognosis of post-resuscitation disease [12]. Jochberger et al [13] reported that serum ADH concentrations in patients after cardiac surgery (n = 96; 19.5 ± 30.4 pg/mL) were significantly higher than patients with sepsis (n = 25; 6.5 ± 4.3 pg/mL), and patients admitted for non-surgical diseases (n = 51; 6.5 ± 4.3 pg/mL; P < 0.001).…”
Section: Discussionmentioning
confidence: 99%
“…During CPR and the immediate post-resuscitation phase, pro-inflammatory cytokines (TNF-a, IL-1, IL-6) are released, which dysregulate the axis and lead to adrenal insufficiency as reflected by low cortisol levels [24, 26]. The pituitary response to the hypothalamic corticotropin releasing hormone and the synthesis and release of cortisol from ACTH-stimulated adrenocortical cells is suppressed by the systemic inflammation [27].…”
Section: Pathophysiology Of the Hpa Axis During Ca And Cprmentioning
confidence: 99%
“…Their various effects include alterations in carbohydrate, lipid, and protein metabolism and maintenance of electrolyte and fluid balance [26]. Glucocorticoids increase blood glucose concentrations and facilitate the delivery of glucose to cells during acute stress [26], increasing the rate of hepatic gluconeogenesis and inhibiting adipose tissue glucose uptake [27]. Glucocorticoids also supply energy to the cell by stimulating free fatty-acid release from adipose tissue and amino-acid release from proteins.…”
Section: Actions Of Glucocorticoidsmentioning
confidence: 99%
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