Changes in serum cortisol levels during community-acquired pneumonia: The influence of dexamethasone
Respiratory Medicine,  Clinical Article

Remmelts HHF et al. - The authors showed that an adverse outcome of community-acquired pneumonia (CAP) was associated with persisting higher total serum cortisol throughout the course of disease. Delta-cortisol could be another meaningful biomarker in CAP. Next, the data indicate that a four-day dexamethasone regimen during CAP does not lead to prolonged secondary adrenal insufficiency.

Methods
  • The authors analyzed data from 270 hospitalized patients with CAP.
  • Total serum cortisol was measured on presentation, day 1, 2, 4, and on control visit (day 30).
  • Intensive care unit (ICU) admission and mortality were assessed.
  • Additionally, to study the influence of dexamethasone on the kinetics of the cortisol response, the authors analyzed serial cortisol values of 43 patients treated with a four-day regimen of dexamethasone 5 mg.

Results
  • During hospital stay, 26/270 patients (9.6%) were admitted to the ICU and 15/270 patients (5.6%) died.
  • Compared to patients with an uneventful recovery, cortisol on presentation was significantly higher in patients with an adverse outcome (360 μg/L, IQR 209-597 vs. 238 μg/L, IQR 151-374) (p:0.01), and also remained significantly higher throughout the course of disease.
  • Dexamethasone treatment resulted in nearly complete suppression of the endogenous cortisol production after the first dose, but cortisol production was fully recovered on control visit.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Nursing

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Nursing Articles

1 Yogurt consumption, weight change and risk of overweight/obesity: The SUN cohort study Nutrition, Metabolism & Cardiovascular Diseases, July 28, 2014    Clinical Article

2 Vitamin D and sleep disorders Full Text Nature and Science of Sleep, August 13, 2014    Free full text    Clinical Article

3 Blood pressure in relation to coffee and caffeine consumption Current Hypertension Reports, August 8, 2014    Review Article

4 Metformin in chronic kidney disease: Time for a rethink Peritoneal Dialysis International, July 9, 2014    Clinical Article

5 Suffering from constipation? Self-acupressure can help UCLA Health System, November 19, 2014

6 Effect of ginger (Zingiber officinale) on heavy menstrual bleeding: a placebo-controlled, randomized clinical trial Phytotherapy Research, October 13, 2014    Clinical Article

7 UAB plans clinical trial for repurposed drug shown to reverse diabetes UAB Medicine, November 12, 2014

8 Long-term associations of nut consumption with body weight and obesity American Journal of Clinical Nutrition, June 23, 2014    Clinical Article

9 Decreased ability to identify odors can predict death The University of Chicago Medical Center News, October 3, 2014

10 Chocolate intake and diabetes risk Clinical Nutrition, July 21, 2014    Clinical Article

11 Vitamin D and the risk of dementia and Alzheimer's disease Neurology®, August 27, 2014    Clinical Article

12 Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: A comprehensive review and meta-analysis European Journal of Cancer, August 7, 2014    Review Article

13 Study identifies best way to treat neck pain Johns Hopkins Medicine, October 24, 2014

14 Yogurt and weight management American Journal of Clinical Nutrition, April 3, 2014    Review Article

15 Proton pump inhibitors decrease diversity in gut microbiome, increase risk for complications Mayo Clinic, November 25, 2014

16 'Tis the season to indulge in walnuts UC Davis Health System, November 17, 2014

17 Fish consumption and risk of gastrointestinal cancers: A meta-analysis of cohort studies Full Text World Journal of Gastroenterology, November 17, 2014    Free full text    Evidence Based Medicine

18 Associations of sugar and artificially sweetened soda and chronic kidney disease: A systematic review and meta-analysis Nephrology, September 24, 2014    Evidence Based Medicine    Review Article

19 Eating habits, body fat related to differences in brain chemistry Full Text NIH News, September 10, 2014    Free full text

20 Dairy product consumption and gastric cancer risk: A meta-analysis Full Text World Journal of Gastroenterology, November 14, 2014    Free full text    Evidence Based Medicine

Indexed Journals in Nursing: Journal of Advanced Nursing, Journal of Clinical Nursing, Nurse Education In Practicemore