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Endocrine alterations in critically III patients with stroke during the early recovery period

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Abstract

Introduction: Endocrine abnormalities in critically ill patients with stroke during the early recovery period have not been well characterized.

Methods: To investigate this issue, 33 consecutive mechanically ventilated patients (27 men) with hemorrhagic (n=21) or ischemic (n=12) stroke having a mean age of 57 ± 12 years were studied. Glasgow Coma Scale score on admission in the hospital was 8 ± 3. The following basal hormones were measured within 72 hours postextubation: cortisol, corticotropin (ACTH), free thyroxine, tri-iodothyronine, thyroid-stimulating hormone, testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, growth hormone, and insulin-like growth factor (IGF)-1. Subsequently, a low-dose (1 µg) ACTH stimulation test was performed.

Results: Twenty-six (79%) patients showed endocrine alterations. The most common change was low IGF-1 levels compatible with growth hormone deficiency (45%), followed by hypogonadism (39%), thyroid dysfunction (36%), and cortisol hyporesponsiveness (33%).

Conclusion: Neuroendocrine changes occur with high frequency in critically ill patients with stroke during the early recovery period. It remains to be determined whether these changes have implications for functional and/or clinical outcome.

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Authors and Affiliations

  1. Department of Critical Care Medicine, Diabetes & Metabolism, Evangelismos Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece

    Ioanna Dimopoulou (Assistant Professor), Stylianos Orfanos & Apostolos Armaganidis

  2. Department of Neurosurgery, Diabetes & Metabolism, Evangelismos Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece

    Andreas T. Kouyialis

  3. Department of Endocrinology, Diabetes & Metabolism, Evangelismos Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece

    Marinella Tzanela, Nikolaos Thalassinos & Stylianos Tsagarakis

Authors
  1. Ioanna Dimopoulou
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  2. Andreas T. Kouyialis
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  3. Stylianos Orfanos
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  4. Apostolos Armaganidis
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  5. Marinella Tzanela
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  6. Nikolaos Thalassinos
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  7. Stylianos Tsagarakis
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Correspondence to Ioanna Dimopoulou.

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Dimopoulou, I., Kouyialis, A.T., Orfanos, S. et al. Endocrine alterations in critically III patients with stroke during the early recovery period. Neurocrit Care 3, 224–229 (2005). https://doi.org/10.1385/NCC:3:3:224

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