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Adrenal function and physiologic stress during acute asthma exacerbation

R K Cydulka1, C L Emerman

  • 1Department of Emergency Medicine, Metro Health Center, Cleveland, OH, USA. rcydulka@metrohealth.org

Annals of Emergency Medicine
|May 15, 1998
PubMed
Summary

Asthma exacerbation typically does not cause adrenal suppression in patients. Most asthmatics do not show a significant stress response in adrenal function during an asthma attack.

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Area of Science:

  • Endocrinology
  • Pulmonology
  • Critical Care Medicine

Background:

  • Adrenal function in stable asthmatics is well-documented.
  • The impact of acute asthma exacerbation on adrenal function requires further investigation.

Purpose of the Study:

  • To investigate the effect of asthma exacerbation on adrenal function in non-steroid-dependent adult asthmatics.

Main Methods:

  • Observational cohort study of 74 adult asthma patients presenting to the emergency department.
  • Assessed pulmonary function and measured plasma cortisol levels before and after cosyntropin stimulation.
  • Standard asthma therapy was initiated after baseline measurements.

Main Results:

  • Most patients (74) did not exhibit adrenal suppression upon presentation.

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  • Elevated cortisol levels (>20 µg/dL) were observed in 16% of patients, indicating physiological stress.
  • A significant association was found between physiological stress markers and severe airflow obstruction (P < .03).

    • Conclusions:

    • Adrenal suppression is uncommon in asthma patients presenting with exacerbation.
    • Asthma exacerbation does not typically elicit a significant adrenal stress response in most patients.