Abstract
Aim: Although adrenal insufficiency (AI) is a rarely seen condition in critically ill cases (2-3%), it is reported that relative AI is encountered more frequently. In this study, our aim was to detect the frequency of AI using standard dose corticotropin (ACTH) test in patients with critical illness and to determine IL-6, aldosteron, BAL cortisol, procalcitonine and 24-hour uriner cortisol values effects of the prognosis.
Material and method: A total of 80 patients with acute critical illness were recruited to the study. The patients were divided into two groups according to the applications of IMV and NIMV. Vital findings and APACHE II scoring were recorded and blood samples were taken for ACTH and cortisol. Furthermore, standard dose (250 μg) ACTH test was done for AI diagnosis.
Results: AI defined in patients according to the basal cortisol < 15 μg/dl and/or the delta cortisol < 9 μ g/dl. AI were determined in 18 patients (22,5%). AI was detected in 6 (15%) of the 40 patients who were received IMV. Thirty two of these 40 patients died. AI was determined at 4 (12.5%) of these 32 patients who were died. There was AI in 12 (30%) of 40 patients to whom NIMV was applied. 12 of these 40 patients died. Two (16,7%) of these 12 patients who died had AI. In patients with and without AI, there was no significant difference with respect to the mortality rates at the IMV and NIMV group (p>0.05).
Conclusion: The frequency of AI was common in patients with critical illness. AI was determined more frequently at the NIMV group. We think that adrenal functions should be routinely followed in the intensive care even though there was no clinical finding.
- © 2011 ERS