Skip to main content
Log in

Cortisol and catecholamine kinetics during continuous hemodiafiltration in patients with multiple organ dysfunction syndrome

  • Original
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Objective

To assess the influence of continuous hemodiafiltration (CHDF) on cortisol and catecholamine kinetics in multiple organ dysfunction syndrome.

Design

Consecutive clinical study.

Setting

General intensive care unit of a university hospital.

Patients

Ten adult patients with multiple organ dysfunction syndrome requiring CHDF.

Measurements and results

A total of 40 samples were collected during CHDF for cortisol and catecholamine assays. The clearances for cortisol, epinephrine, norepinephrine and dopamine were 2.5±1.7 ml/min, 26.3±2.7 ml/min, 16.7±4.2 ml/min and 26.3±2.6 ml/min (Mean±SE), and their daily extractions were 1.8±0.2 mg/day, 11.4±4.8 μg/day, 1.0±0.1 μg and 2.3±0.3 μg/day, respectively. There were no significant changes in blood cortisol and catecholamine levels during CHDF conducted for 48 h.

Conclusions

The cortisol and catecholamine losses during CHDF were small and unlikely to lead to hemodynamic disturbances.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Canaud B, Cristol JP, Berthelemy C, Klouche K, Beraud JJ, Mion C (1991) Acute renal failure associated with multiple organ failure. Pump-assisted continuous venovenous hemofiltration, the ultimate treatment modality. Contrib Nephrol 93: 32–38

    Google Scholar 

  2. Bagshaw ONT, Anaes FRC, Hutchinson A (1992) Continuous arteriovenous haemodiafiltration and respiratory function in multiple organ system failure. Intensive Care Med 18: 334–338

    Google Scholar 

  3. Hirasawa H, Sugai T, Ohtake Y, Oda S, Shiga H, Matsuda K, Kitamura N (1991) Continuous hemodiafiltration and hemodiafiltration in the management of multiple organ failure. Contrib Nephrol 93: 42–46

    Google Scholar 

  4. Dorin RI, Kearns PJ (1988) High output circulatory failure in acute adrenal insufficiency. Crit Care Med 16: 296–297

    Google Scholar 

  5. Golper TA (1991) Drug removal during continuous hemofiltration or hemodialysis. Contrib Nephrol 93: 110–116

    Google Scholar 

  6. Bellomo R, McGrath B, Boyce N (1991) In vivo catecholamine extraction during continuous hemodiafiltration in inotrope-dependent patients. ASAIO Trans 37: M324-M325

    Google Scholar 

  7. Bellomo R, Colman PG, Caudwell J, Boyce N (1992) Acute continuous hemofiltration with dialysis: effect on insulin concentrations and glycemic control in critically ill patients. Crit Care Med 20: 1672–1676

    Google Scholar 

  8. Grootendorst AF, Van Bommel EFH, Van der Hoven B, Van Leengoed LA, Van Osta AL (1992) High volume hemofiltration improves right ventricular function in endotoxin-induced shock in the pig. Intensive Care Med 18: 235–240

    Google Scholar 

  9. Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) Prognosis in acute organ-system failure. Ann Surg 202: 685–693

    Google Scholar 

  10. Rudd BT, Cowper JM, Crawford N (1961) The determination of plasma free hydrocortisone and corticosterone by a combined fluorimetric and modified Porter-Silber procedure. Clin Chim Acta 6: 686–695

    Google Scholar 

  11. Kudo M, Kudo T, Oyama T (1984) The simultaneous determination of plasma concentration of norepinephrine, epinephrine and dopamine by gaschromatography-mass spectrometry. Masui 33: 1099–1103

    Google Scholar 

  12. Bellomo R, Tipping P, Boyce N (1993) Continuous veno-venous hemofiltration with dialysis removes cytokines from the circulation of septic patients. Crit Care Med 21: 522–526

    Google Scholar 

  13. Baxter JD, Tyrrell JB (1987) The adrenal cortex. In: Feilig P, Baxter JD, Broadus AE (eds) Endocrinology and Metabolism, 2nd edn. McGraw-Hill, New York, pp 1157–1177

    Google Scholar 

  14. Kitunai Y (1982) Effect of hemodialysis on pituitary-adrenal function. Nichijinshi 24: 235–252

    Google Scholar 

  15. Dolecek R, Brizio-Molteni L, Molteni A (1990) The pituitary-adrenal axis. In: DoLecek R, Brizio-Molteni L, Moltein A, Traber D (eds) Endocrinology of thermal trauma. Lea & Febiger, Pennsylvania, pp 62–99

    Google Scholar 

  16. Drucker D, Shandling M (1985) Variable, adrenocortical function in acute medical illness. Crit Care Med 13: 477–479

    Google Scholar 

  17. Sibbald WJ, Short A, Cohen MP, Wilson RF (1977) Variations in adrenocortical responsiveness during severe bacterial infections. Ann Surg 186: 29–33

    Google Scholar 

  18. Mann H, Konigs F, Heinz B, Gladziwa U, Kirsten R, Stiller S (1990) Vasoactive hormones during hemodialysis with intermittent ultrafiltration. ASAIO Trans 36: M367–369

    Google Scholar 

  19. Harrison TS, Gann DS, Edis AJ, Egdahl RH (1975) Surgical disorders of the adrenal gland: physiologic background and treatment. Grune & Stratton. New York, pp 63–121

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tsubo, T., Hashimoto, Y., Araki, I. et al. Cortisol and catecholamine kinetics during continuous hemodiafiltration in patients with multiple organ dysfunction syndrome. Intensive Care Med 22, 1176–1178 (1996). https://doi.org/10.1007/BF01709332

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01709332

Key words

Navigation