Decreased adrenal responsiveness in hypothermic patients.
We have performed ACTH simulation tests in a total of 14 subjects who were hypothermic at the time of initial presentation. Plasma cortisol values were measured before and 1 h after an iv dose of 25 U synthetic ACTH. The cortisol response was depressed in these subjects, with a mean rise of 32% and an absolute mean rise of 5.0 microgra/dl. There appeared to be a temperature threshold effect, with only minimal responses observed below 32 C. A subgroup of 5 patients with sluggish responses to ACTH while hypothermic (mean cortisol rise, 12.5%) were retested after warming and responded normally (mean rise, 166%). Thus, ACTH stimulation tests may be misleading in the hypothermic patient and should be performed only after body temperature has returned to normal.
D000311:Adrenal Glands / Q000503:physiopathology*; D000324:Adrenocorticotropic Hormone; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001831:Body Temperature; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007035:Hypothermia / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D012964:Sodium / Q000097:blood
D000324:Adrenocorticotropic Hormone; D012964:Sodium; D011188:Potassium; D006854:Hydrocortisone