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Cortisol and catecholamine kinetics during continuous hemodiafiltration in patients with multiple organ dysfunction
T Tsubo1, Y Hashimoto, I Araki
1Intensive care Unit, University of Hirosaki, School of Medicine, Aomori-ken, Japan.
Intensive Care Medicine
|November 1, 1996
Summary
Continuous hemodiafiltration (CHDF) minimally impacts cortisol and catecholamine levels in multiple organ dysfunction syndrome patients. These small losses during CHDF are unlikely to cause hemodynamic instability.
Area of Science:
- Intensive Care Medicine
- Nephrology
- Endocrinology
Background:
- Multiple organ dysfunction syndrome (MODS) is associated with significant alterations in stress hormone levels.
- Continuous hemodiafiltration (CHDF) is a common renal replacement therapy in critically ill patients.
Purpose of the Study:
- To evaluate the impact of CHDF on the kinetics of cortisol and catecholamines in patients with MODS.
- To quantify the removal of these hormones during CHDF therapy.
Main Methods:
- A consecutive clinical study was conducted in a university hospital's general intensive care unit.
- Ten adult patients with MODS requiring CHDF were enrolled.
- Cortisol and catecholamine levels were measured in 40 samples collected during CHDF.
Main Results:
- Clearances for cortisol, epinephrine, norepinephrine, and dopamine during CHDF were determined.
- Daily extraction amounts for these hormones were calculated.
- No significant changes in blood cortisol and catecholamine levels were observed during 48 hours of CHDF.
Conclusions:
- The study found small losses of cortisol and catecholamines during CHDF.
- These losses are unlikely to result in significant hemodynamic disturbances in MODS patients.