Endocrine alterations in critically III patients with stroke during the early recovery period

• Published in: Neurocritical care 2005-12, Vol.3 (3), p.224-229
• Main Authors: Dimopoulou, Ioanna, Kouyialis, Andreas T, Orfanos, Stylianos, Armaganidis, Apostolos, Tzanela, Marinella, Thalassinos, Nikolaos, Tsagarakis, Stylianos
• Format: Article
• Language: English
• Subjects: Growth hormones; Insulin-like growth factors; Stroke; Thyroid gland
• ISSN: 1541-6933; 1556-0961
• DOI: 10.1385/NCC:3:3:224

Introduction: Endocrine abnormalities in critically ill patients with stroke during the early recovery period have not been well characterized.Methods: To investigate this issue, 33 consecutive mechanically ventilated patients (27 men) with hemorrhagic (n=21) or ischemic (n=12) stroke having a mean age of 57 ± 12 years were studied. Glasgow Coma Scale score on admission in the hospital was 8 ± 3. The following basal hormones were measured within 72 hours postextubation: cortisol, corticotropin (ACTH), free thyroxine, tri-iodothyronine, thyroid-stimulating hormone, testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, growth hormone, and insulin-like growth factor (IGF)-1. Subsequently, a low-dose (1 µg) ACTH stimulation test was performed.Results: Twenty-six (79%) patients showed endocrine alterations. The most common change was low IGF-1 levels compatible with growth hormone deficiency (45%), followed by hypogonadism (39%), thyroid dysfunction (36%), and cortisol hyporesponsiveness (33%).Conclusion: Neuroendocrine changes occur with high frequency in critically ill patients with stroke during the early recovery period. It remains to be determined whether these changes have implications for functional and/or clinical outcome.