The Prevalence of Functional Adrenal Insufficiency in Patients with Coagulation Disorder in the Intensive Care Unit, Alzahra Hospital, Iran

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Adrenal bleeding in trauma, sepsis and other clinical complications is among the most common mechanism for functional adrenal insufficiency. The aim of this study was to evaluate the prevalence of functional adrenal insufficiency in patients with coagulation disorder in the intensive care unit (ICU) of Alzahra Hospital, Isfahan, Iran in 2008-2010.Methods: This descriptive study was performed on 80 patients (aged 18-65 years) in the ICU of Alzahra Hospital. After obtaining informed consents, blood samples of patients were tested for cortisol levels and coagulation factors on the first, third, 7th and 14th days.  The data was collected in a checklist and then analyzed by chi-square test, t-test and one-way analysis of variance (ANOVA) in SPSS18.Findings: There were 39 (48.8%) females and 41 (51.2%) males among the 80 studied patients. Mean coagulation disorders was 5.3 ± 2.1 in men and 4.08 ± 1.97 in women. There was a relation between coagulation disorder and sex (P = 0.009). Our results also showed a relation between coagulation disorder and functional adrenal insufficiency. Conclusion: We found a relation between coagulation disorder and functional adrenal insufficiency

Keywords

References

  1. Sunit C. Adrenal insufficiency of critical illness. Indian Pediatrics 2002; 39: 1011-6.
  2. Moraes RB, Czepielewski MA, Friedman G, Borba EL. Diagnosis of adrenal failure in critically ill patients. Arq Bras Endocrinol Metabol 2011; 55(5): 295-302.
  3. Beishuizen A, Thijs LG. Relative adrenal failure in intensive care: an identifiable problem requiring treatment? Best Pract Res Clin Endocrinol Metab 2001; 15(4): 513-31.
  4. Odeniyi IA, Fasanmade OA, Ajala MO, Ohwovoriole AE. Adrenocortical function in Nigerian patients with pulmonary tuberculosis (PTB). Afr J Med Med Sci 2011; 40(1): 33-8.
  5. Hall JB. Incidence of adrenal insufficiency in critically ill patients. Accessmedicine 2005; 5(2): 293-300.
  6. Goodarzi M. Adrenal axis. Endocrinology 2010; 12: 344-48.
  7. Shenker Y, Skatrud JB. Adrenal Insufficiency in Critically Ill Patients. Am J Respir Crit Care Med 2001; 163(7): 1520-3.
  8. Kurtz LE, Yang S. Bilateral adrenal hemorrhage associated with heparin induced thrombocytopenia. Am J Hematol 2007; 82(6): 493-4.
  9. Farmer C, Annane D, Marik P. Pro/Con: Diagnosing adrenal failure in the critically ill. Proceedings of the Annual Meeting of the Society of Critical Care Medicine; 2004 Feb 24; Orlando, Fla; 2004.
  10. Poulain G, Lamberto C, Coche E, Hainaut P, Lambert M. Acute adrenal insufficiency associated with heparin-induced thrombocytopenia. Acta Clin Belg 2008; 63(2): 112-5.
  11. Carr ME, Martin EJ. Evolving techniques for monitoring clotting in plasma and whole blood samples. Clin Lab 2004; 50(9-10): 539-49.
  12. Marini JM, Wheeler AP. Critical care medicine: the essentials. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.
  13. Bleasel JF, Rasko JE, Rickard KA, Richards G. Acute adrenal insufficiency secondary to heparin-induced thrombocytopenia-thrombosis syndrome. Med J Aust 1992; 157(3): 192-3.
  14. Delhumeau A, Moreau X, Chapotte C, Houi N, Bigorgne JC. Heparin-associated thrombocytopenia syndrome: an underestimated etiology of adrenal hemorrhage. Intensive Care Med 1993; 19(8): 475-7.
  15. Delhumeau A, Houet JF, Bourrier P, Bukowski JG, Granry JC. Heparin-induced thrombocytopenia complicated by hematoma of the adrenal glands and acute adrenal insufficiency. Ann Fr Anesth Reanim 1989; 8(6): 656-8.
Journal of Isfahan Medical School
Volume 29, Issue 168 - Serial Number 168
November and December 2012
Pages 2468-2474

Files

History

  • Receive Date: 18 September 2011
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics