Endocrine Abstracts

Aim: To assess hormonal function of cortex of adrenal glands in patients (pts) after cardiac arrest (CA) and its role for survival.

Material: CA-pts- 52 pts after CA in the age 62±13 years. 26 pts died after CA (CA-D-pts), 26 pts survived and were discharged from hospital (CA-S-pts). H-pts- 22 pts in the age 60±11 years with stable coronary artery disease.

Methods: In CA-pts concentrations(conc) of adrenocorticotropin (ACTH), cortisol, aldosterone nad dehydroepiandrosterone sulfate were measured in venous blood samples taken just after CA and in two consecutive days at 8.00 am. Conc of this hormones in H-pts were measured once, at. 8.00 am. A comparison of conc of the hormones between CA-D-pts and CA-S-pts was performed.

Results: Significantly higher conc of ACTH and cortisol was found in CA-pts than in H-pts in each day after CA. Conc of aldosterone was higher in CA-pts only just after CA. No difference in conc of dehydroepiandrosterone sulfate between these groups was found.

Compared to CA-S-pts, in CA-D-pts conc of ACTH was lower just after CA (5.2±10.8 vs 7.9±7.7 nmol/l, P<0.037). Conc of cortisol was higher in CA-D-pts than in CA-S-pts just after CA (3733±5869 vs 1635±1484 nmol/l, P<0.1) and in the first (2084±2119 vs 1084±722 nmol/l, P<0.034) and the second day (1325±1083 vs 711±401 nmol/l, P<0.03) after CA.

Conclusions: (1) ACTH- cortisol response plays an important role for survival in pts after CA; (2) Significantly higher conc of cortisol in CA-D-pts, in comparison to CA-S-pts, suggests extremal involvement of this formone for the attempt of survival after CA and may indicate pts in severe state after CA need substitutional administration of cortisol; (3) Incomparable elevated conc of ACTH to high conc of cortisol is a marker of bad prognosis after in pts after CA.