Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Relative adrenal insufficiency and hemodynamic status in cardiopulmonary bypass surgery patients. A prospective cohort study. | Iribarren et al. Journal of Cardiothoracic Surgery 2010 5 26 http content 5 1 26 Jdfrs JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Relative adrenal insufficiency and hemodynamic status in cardiopulmonary bypass surgery patients. A prospective cohort study José L Iribarren 1 Juan J Jimenez1 Domingo Hernandez2 Lisset Lorenzo1 Maitane Brouard1 Antonio Milena3 María LMora1 and Rafael Martinez4 Abstract Background The objectives of this study were to determine the risk factors for relative adrenal insufficiency in cardiopulmonary bypass patients and the impact on postoperative vasopressor requirements. Methods Prospective cohort study on cardiopulmonary bypass patients who received etomidate or not during anesthetic induction. Relative adrenal insufficiency was defined as a rise in serum cortisol 9 gg dl after the administration of 250 gg of consyntropin. Plasma cortisol levels were measured preoperatively immediately before 30 60 and 90 minutes after the administration of cosyntropin and at 24 hours after surgery. Results 120 elective cardiopulmonary bypass patients were included. Relative adrenal insufficiency Acortisol 9 gg dl incidence was . 78 patients received etomidate and 69 88 of them developed relative adrenal insufficiency P . Controlling for clinical characteristics with a propensity analysis etomidate was the only independent risk factor associated with relative adrenal insufficiency OR CI 95 P . Relative adrenal insufficiency patients showed more vasopressor requirements just after surgery P and at 4 hours after surgery P . Pre and post-test plasma cortisol levels were inversely associated with maximum norepinephrine dose p P p P p P and p P respectively . Conclusions Relative adrenal insufficiency in elective cardiopulmonary bypass patients may induce postoperative vasopressor dependency. Use of etomidate in these patients
