title: Serum cortisol level and adrenal reserve as a predictor of patients' outcome after successful cardiopulmonary resuscitation.
abstract: BACKGROUND
  It is thought that pituitary-adrenal axis has a fundamental role in outcome of cardiopulmonary arrest (CPA). This study designed to evaluate the correlation between adrenal reserve and post-resuscitation outcome.
  
  
  METHODS
  In this clinical trial study, 52 consecutive patients with CPA were enrolled in two emergency departments (EDs) over a 3-month period. Plasma cortisol level was measured at the beginning of CPR. Intravenous adrenocorticotropic hormone (ACTH) stimulation test was carried out after successful CPR, and blood samples were taken at 30 and 60 minutes, and 24 hours thereafter. Patients were divided into two groups: in-hospital death or hospital discharge.
  
  
  RESULTS
  In patients who died, baseline and post-ACTH serum cortisol after 30 and 60 minutes and 24 hours were higher than patients who discharged from the hospital, but it was not statistically significant except to that of minute 60 (P=0.49). A model of multivariate logistic regression analysis showed that age and need for vasopressor infusion correlated with mortality.
  
  
  CONCLUSIONS
  Current study could not show the statistically significant difference in initial and post-ACTH serum cortisol levels between survivor and non-survivor patients with cardiac arrest who had initial successful CPR, except to that of minute 60.
authors.affiliation: Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Mosaddegh
authors.affiliation: Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Kianmehr
authors.affiliation: Emergency Management Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Mahshidfar
authors.affiliation: Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Rahmani
authors.affiliation: Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
authors.forename: Hamed
authors.initials: H
authors.lastname: Aghdam
authors.affiliation: Emergency Management Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mani
authors.initials: M
authors.lastname: Mofidi
keywords: Adrenal Insufficiency; Cardiopulmonary Arrest; Cardiopulmonary Resuscitation; Cortisol Level; Pituitary-Adrenal Axis; Return of Spontaneous Circulation