Hospital Universitari Son Dureta andrea Doria 55

Palma, Spain

Hospital Universitari Son Dureta andrea Doria 55

Palma, Spain

Time filter

Source Type

Llompart-Pou J.A.,Hospital Universitari Son Dureta andrea Doria 55 | Perez G.,Son Dureta University Hospital | Perez-Barcena J.,Hospital Universitari Son Dureta andrea Doria 55 | Brell M.,Son Dureta University Hospital | And 8 more authors.
Journal of Endocrinological Investigation | Year: 2010

Introduction: Brain cortisol availability has never been evaluated in patients with traumatic brain injury (TBI). Cerebral microdialysis is a well-established technique for monitoring brain metabolism in neurocritically ill patients, which may be used to measure interstitial cortisol. The objective of this preliminary study was to measure brain interstitial cortisol and its correlation with total serum cortisol in patients with TBI. Methods: We prospectively studied 6 patients with severe TBI admitted to the Intensive Care Unit of our tertiary University Hospital in which multimodal neuromonitoring including cerebral microdialysis with a high cut-off of 100 k-Da and 20-mm long membrane was used. Serum and brain interstitial cortisol microdialysis samples were obtained every 8 h and analyzed afterwards. Results: Linear regression analysis of total serum cortisol and brain interstitial cortisol in the whole population showed a moderate correlation (R2=0.538, p<0.001, no.=118). However, intra-individual correlation showed a great variability, with correlation coefficients ranging from a R2=0.091 to R 2=0.680. Conclusion: Our prospective and preliminary study showed a moderate correlation of brain interstitial cortisol and total serum cortisol values in patients with diffuse TBI. However, intra-individual analysis showed a great variability. These results suggest that total serum cortisol may not reflect brain cortisol availability in half of TBI patients. ©2010, Editrice Kurtis.


Raurich J.-M.,Hospital Universitari Son Dureta andrea Doria 55 | Rialp G.,Son Llatzer Hospital | Ibanez J.,Hospital Universitari Son Dureta andrea Doria 55 | Llompart-Pou J.A.,Hospital Universitari Son Dureta andrea Doria 55 | Ayestaran I.,Hospital Universitari Son Dureta andrea Doria 55
Respiratory Care | Year: 2010

OBJECTIVE: In obesity-hypoventilation-syndrome patients mechanically ventilated for hypercapnic respiratory failure we investigated the relationship between CO 2 response, body mass index, and plasma bicarbonate concentration, and the effect of acetazolamide on bicarbonate concentration and CO 2 response. METHODS: CO 2 response tests and arterial blood gas analysis were performed in 25 patients ready for a spontaneous breathing test, and repeated in a subgroup of 8 patients after acetazolamide treatment. CO 2 response test was measured as (1) hypercapnic drive response (the ratio of the change in airway occlusion pressure 0.1 s after the start of inspiratory flow to the change in P aCO2), and (2) hypercapnic ventilatory response (the ratio of the change in minute volume to the change in P aCO2). RESULTS: We did not find a significant relationship between CO 2 response and body mass index. Patients with higher bicarbonate concentration had a more blunted CO 2 response. Grouping the patients according to the first, second, and third tertiles of the bicarbonate concentration, the hypercapnic drive response was 0.32 ± 0.17 cm H 2O/mm Hg, 0.22 ± 0.15 cm H 2O/mm Hg, and 0.10 ± 0.06 cm H 2O/mm Hg, respectively (P =.01), and hypercapnic ventilatory response was 0.46 ± 0.23 L/min/mm Hg, 0.48 ± 0.36 L/min/mm Hg, and 0.22 ± 0.16 L/min/mm Hg, respectively (P =.04). After acetazolamide treatment, bicarbonate concentration was reduced by 8.4 ± 3.0 mmol/L (P =.01), and CO 2 response was shifted to the left, with an increase in hypercapnic drive response, by 0.14 ± 0.16 cm H 2O/mm Hg (P =.02), and hypercapnic ventilatory response, by 0.11 ± 0.22 L/min/mm Hg (P =.33). CONCLUSIONS: Patients with obesity-hypoventilation syndrome and higher bicarbonate concentrations had a more blunted CO 2 response. Body mass index was not related to CO 2 response. Acetazolamide decreased bicarbonate concentration and increased CO 2 response. © 2010 Daedalus Enterprises.


Llompart-Pou J.A.,Hospital Universitari Son Dureta andrea Doria 55 | Perez G.,Hospital Universitari Son Dureta andrea Doria 55 | Raurich J.M.,Hospital Universitari Son Dureta andrea Doria 55 | Riesco M.,Hospital Universitari Son Dureta andrea Doria 55 | And 6 more authors.
Neurocritical Care | Year: 2010

Background: Traumatic brain injury (TBI) is commonly associated with disturbances of the hypothalamic-pituitary-adrenal axis secretion. Cerebral microdialysis techniques have been recently applied to measure brain interstitial cortisol levels. Methods: We evaluated for the first time the circadian rhythm of cortisol secretion at 08:00, 16:00, and 24:00 h in the acute phase of TBI by determination of total serum and brain interstitial cortisol levels (microdialysis samples) in 10 patients with TBI. Non-parametric Friedman's two way analysis of variance test was used. Results: Mean age was 29.8 ± 13.6 years. Median Glasgow Coma Scale score after resuscitation was 5 (range 3-10). No differences were found in total serum (P = 0.26) and brain interstitial cortisol (P = 0.77) in the whole sample. Intraindividual analysis showed that circadian variability was lost in all patients, both in serum and brain interstitial cortisol samples in the acute phase after TBI. Conclusion: In our series, circadian variability of cortisol evaluated by serum and cerebral microdialysis samples seems to be lost in TBI patients. © 2010 Springer Science+Business Media, LLC.

Loading Hospital Universitari Son Dureta andrea Doria 55 collaborators
Loading Hospital Universitari Son Dureta andrea Doria 55 collaborators