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2 "Jung Hee Kim"
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Basic science and research
Comparison of salivary and serum cortisol levels in mechanically ventilated patients and non-critically ill patients
Jung Hee Kim, Yoon Ji Kim, Sang-Min Lee, Jinwoo Lee
Acute Crit Care. 2020;35(3):149-155.   Published online August 31, 2020
DOI: https://doi.org/10.4266/acc.2020.00297
  • 4,922 View
  • 116 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Although the measuring free cortisol is ideal for assessment of hypothalamicpituitary-adrenal function, it is not routinely measured. Salivary cortisol correlates well with the biologically active free cortisol. Therefore, this study measured the morning basal as well as adrenocorticotropic hormone-stimulated salivary cortisol levels in mechanically ventilated patients and compared the results with non-critically ill patients.
Methods
We prospectively enrolled 49 mechanically ventilated patients and 120 patients from the outpatient clinic. Serum and saliva samples were collected between 8 AM and 10 AM. Salivary cortisol levels were measured using an enzyme immunoassay kit. The salivary samples were insufficient in 15 mechanically ventilated patients (30.6%), and these patients were excluded from the final analysis.
Results
Mechanically ventilated patients (n=34) were significantly older and had lower body mass index and serum albumin levels and higher serum creatinine levels than non-critically ill patients (n=120). After adjustment for these parameters, both basal and stimulated salivary and serum cortisol levels were higher in mechanically ventilated patients. The increase in cortisol was not significantly different between the two groups. Serum cortisol levels showed a positive correlation with salivary cortisol levels. Among mechanically ventilated patients, both basal serum and salivary cortisol levels were lower in survivors than in non-survivors.
Conclusions
Both basal total serum and salivary cortisol levels were elevated in mechanically ventilated patients and in non-survivors.

Citations

Citations to this article as recorded by  
  • Associations between chronic work stress and plasma chromogranin A/catestatin among healthy workers
    Xin Liu, Weimin Dang, Hui Liu, Yao Song, Ying Li, Weixian Xu
    Journal of Occupational Health.2022;[Epub]     CrossRef
Basic science and research
Prognostic Implication of Adrenocortical Response during the Course of Critical Illness
Jin Hwa Song, Jung Hee Kim, Sang-Min Lee, Jinwoo Lee
Acute Crit Care. 2019;34(1):38-45.   Published online January 30, 2019
DOI: https://doi.org/10.4266/acc.2018.00339
  • 7,101 View
  • 127 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary Material
Background
Critical illness-related corticosteroid insufficiency (CIRCI) and adrenocorticotropic hormone (ACTH)-cortisol dissociation are hormonal conditions frequently observed in patients in the intensive care unit (ICU). The aim of this study was to evaluate the association between ACTH-cortisol dissociation and clinical outcomes of critically ill patients. Methods: We retrospectively reviewed the medical records of 94 ICU patients who underwent two rapid cosyntropin tests during hospital admission and compared the clinical aspects of patients with and without ACTH-cortisol dissociation. ACTH-cortisol dissociation was defined as plasma ACTH and serum cortisol concentrations of <22 pmol/L and >600 nmol/L, respectively. Results: Dissociation was present in 30 of the 94 patients (31.9%). Patients with ACTH-cortisol dissociation in the initial test had significantly higher hospital mortality rate than those in the control group (55% vs. 25.7%, P=0.013) There was no difference in hospital mortality between patients classified as having CIRCI and those who were not. In multivariate adjusted Cox regression analysis, the mortality risk was higher in the group with ACTH-cortisol dissociation (hazard ratio, 2.98; 95% confidence interval, 1.34 to 6.63; P=0.007). Patients with dissociation in two consecutive stimulation tests showed the highest hospital mortality rate among groups classified according to stimulation test results (100% vs. 31.3%). Conclusions: The hospital mortality was higher in ICU patients diagnosed with ACTH-cortisol dissociation. It is clinically feasible to evaluate the presence of ACTH-cortisol dissociation by analyzing rapid ACTH stimulation test results in critically ill patients.

Citations

Citations to this article as recorded by  
  • Serum ACTH and Cortisol Level is Associated with the Acute Gastrointestinal Injury Grade in ICU Patients
    Wen Xu, Yuzhen Qiu, Hongping Qiu, Ming Zhong, Lei Li
    International Journal of General Medicine.2024; Volume 17: 127.     CrossRef
  • PROGNOSTIC VALUE OF LOW-DOSE ADRENOCORTICOTROPIC HORMONE TEST IN CRITICALLY ILL PATIENTS
    Ahmad B. Abdelrehim, Fatma M. Mohsen, Mostafa A. Haredi, Zeinab Abdel Hameed, Walaa H. Ibrahim
    Shock.2023; 59(6): 871.     CrossRef
  • Copeptin and stress-induced hyperglycemia in critically ill patients: A prospective study
    Lilian Rodrigues Henrique, Daisy Crispim, Tarsila Vieceli, Ariell Freires Schaeffer, Priscila Bellaver, Cristiane Bauermann Leitão, Tatiana Helena Rech, Antonio Palazón-Bru
    PLOS ONE.2021; 16(4): e0250035.     CrossRef
  • Comparison of salivary and serum cortisol levels in mechanically ventilated patients and non-critically ill patients
    Jung Hee Kim, Yoon Ji Kim, Sang-Min Lee, Jinwoo Lee
    Acute and Critical Care.2020; 35(3): 149.     CrossRef

ACC : Acute and Critical Care