THE CORTISOL SERUM LEVELS IN PATIENTS WITH SEVERE LUNG INFECTIONS REQUIRING SURGERY

TOPIC: Chest Infections TYPE: Late Breaking PURPOSE: Activation of the hypothalamic-pituitary-adrenal axis represents one several important responses to stressful events and critical illnesses. Despite a large volume published data, controversies continue be debated, such as definition normal adrenal response, concept relative insufficiency, use glucocorticoids in setting illness. Stress-dose glucocorticoid administration may is required during perioperative period because possibility failure cortisol secretion cope with increased requirement due surgical stress, hemodynamic instability, crisis. The aim our study was assess serum levels males acute lung abscess or gangrene requiring surgery determine accordance glucocorticoids. METHODS: (normal range: 170–720 nmol/L) were measured by radio-immune method 80 adult (38 cases) (42 surgery. age patients between 29 84 (Ме [LQ; UQ] – 54.5 [44; 61.5]) years. duration disease at time admission thoracic department ranged from 1 8 (3 [2; 4]) weeks. Pleural empyema diagnosed 40 out (50%) patients, which cases (20% all pleural empyema) had pyopneumothorax, systemic inflammatory response syndrome (SIRS) 43 (54%), sepsis (Sepsis-3) 16 (20%) cases. RESULTS: Cortisol 83 1689 (595 [429; 730]) nmol/L. did not correlate (rS=0.10, p=0.38) (rS=-0.14, p=0.22). differ abscesses (U=756, рMann-Whitney=0.69), depend on presence SIRS, empyema, sepsis, combination both (H=4.04, pKruskal-Wallis=0.54). 6 (8%, 95% confidence interval (CI): 2-14) below 170 (range 145, 94 [89; 100]) 21 (26%, CI: 16-36) above 720 723 1689, 879 [774; 1040]) within range (at 186 718, 526 633] 53 (66%, 56-76) patients. CONCLUSIONS: findings indicate that level varies widely gangrene. It does duration, type complications. Assessment requires laboratory determination. In least 8% low it possible prevent negative consequences stress. effectiveness this approach needs clinical validation. CLINICAL IMPLICATIONS: information can used justification development programs for severe infections. DISCLOSURES: No relevant relationships Siarhei Yermashkevich, source=Web Response