Cortisol and ACTH Measurements at Extubation From Pituitary Surgery Predicts Hypothalamic-Pituitary-Adrenal Axis Function.
Cushing's disease
hypercortisolism
pituitary adenoma
remission
transsphenoidal surgery
Journal
Journal of the Endocrine Society
ISSN: 2472-1972
Titre abrégé: J Endocr Soc
Pays: United States
ID NLM: 101697997
Informations de publication
Date de publication:
09 Feb 2023
09 Feb 2023
Historique:
received:
08
12
2022
entrez:
27
2
2023
pubmed:
28
2
2023
medline:
28
2
2023
Statut:
epublish
Résumé
Early prediction of hypothalamic-pituitary-adrenal (HPA) axis function following transsphenoidal surgery (TSS) can improve patient safety and reduce costs. Systematic measurement of ACTH and cortisol at extubation following anesthesia to predict remission from Cushing's disease (CD) and HPA axis preservation following non-CD surgery. Retrospective analysis of clinical data between August 2015 and May 2022. Referral center. Consecutive patients (n = 129) undergoing TSS who had perioperative ACTH and cortisol measurements. ACTH and cortisol measurement at extubation. Further serial 6-hourly measurements in CD patients. Prediction of future HPA axis status based on ACTH/cortisol at extubation. ACTH and cortisol increased sharply in all patients at extubation. CD patients (n = 101) had lower ACTH values than non-CD patients (110.1 vs 293.1 pg/mL; We found that at extubation following TSS, ACTH can predict the need for eventual steroid replacement in non-Cushing's patients. In patients with CD, we found a robust prediction of nonremission with NEPV cortisol at extubation and later.
Identifiants
pubmed: 36846212
doi: 10.1210/jendso/bvad025
pii: bvad025
pmc: PMC9954986
doi:
Types de publication
Journal Article
Langues
eng
Pagination
bvad025Informations de copyright
Published by Oxford University Press on behalf of the Endocrine Society 2023.
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