0
Abstract: Poster Presentations |

IN PATIENTS WITH PNEUMONIA, ELEVATED CORTISOL LEVEL ON ADMISSION TO THE INTENSIVE CARE UNIT IS ASSOCIATED WITH VASOPRESSOR USE FREE TO VIEW

Renaud Gueret, MD*; Aiman Tulaimat, MD; Guralnick S. Amy, MD; Wisniewski Mary, RN
Author and Funding Information

Cook County Hospital, Chicago, IL


Chest


Chest. 2007;132(4_MeetingAbstracts):555a. doi:10.1378/chest.132.4_MeetingAbstracts.555a
Text Size: A A A
Published online

Abstract

PURPOSE: Cortisol levels correlate with mortality in patients with sepsis. Patients with sepsis evolve into septic shock before developing organ failure, the leading cause of death. The aim of our study was to determine the association between the cortisol level at the time of admission to the ICU and the need for vasopressor (developing shock) and endotracheal intubation in hemodynamically stable patients with pneumonia.

METHODS: Cortisol level was measured in patients admitted to the ICU with the clinical diagnosis of pneumonia. Patients were excluded if they required vasopressors or mechanical ventilation at the time of admission. Patients were prospectively followed for 72 hours to document instances of vasopressor use and intubation.

RESULTS: 44 patients met the inclusion criteria. The patients had the following baseline characteristics: white blood count of 11±8 k/microliter, respiratory rate of 25±7 bpm, heart rate of 108±22 bpm, mean arterial pressure of 94±23 mmHg, temperature of 99±2 degree Fahrenheit, Glasgow Coma Scale of 14±1 and oxygen saturation of 92±7 percent. The patients that required vasopressors (n=11) had higher cortisol levels than patients that did not require vasopressors (35±16 vs. 21±13, p= 0.007). The APACHE III scores were similar between the two groups. The cortisol level remained a powerful predictor of vasopressor use after adjustment for disease severity using the APACHE III score. The cortisol tended to be higher in patients that required mechanical ventilation (n=19) than in patients that did not (28±15 vs. 22 ±15, p=0.2). The APACHE III score was similar between the two groups (47±46 vs. 45±10, p=0.7).

CONCLUSION: In patients admitted to the ICU with the clinical diagnosis of pneumonia, cortisol level is a predictor for vasopressor use.

CLINICAL IMPLICATIONS: Hemodynamically stable patients admitted to the ICU with the clinical diagnosis of pneumonia that have an elevated cortisol level should be aggressively resuscitated with fluid because they are at risk of developing shock that could lead to organ failure.

DISCLOSURE: Renaud Gueret, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, October 24, 2007

12:30 PM - 2:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543