Total plasma cortisol levels during the evolution of the burn patient
Keywords:
burns, cortisol, cholesterol.Abstract
Introduction: Extensive thermal injury produces inflammatory, hormonal and metabolic changes. The hypermetabolic response appears to be driven by inflammatory mediators that induce changes in the hypothalamic-pituitary-adrenal axis; they alter serum cortisol levels, which may be detrimental to the patient's evolution.
Objective: To assess the behavior of serum cortisol during the evolution of the burn patient.
Methods: A descriptive, longitudinal and prospective study was carried out in burn patients. The universe was made up of by patients older than nineteen years, of both sexes, with lesions of 10 % or more of their body surface. Carriers of diseases that modify cortisol levels and patients who died within the first 72 hours of evolution were excluded. The sample consisted of nineteen patients. Serum cortisol was determined on the first morning after admission, at 72 hours and every week. Cholesterol level was determined at the same time. Descriptive statistics and correlation tests were applied according to the type of variable.
Results: Cortisol was found to be very elevated until the first week, with a subsequent tendency to decrease. Cortisol level was not associated with extension or complications. It was not correlated with cholesterol level.
Conclusions: Hypercortisolemia during early evolution did not prove to be related to evolution. However, it is recommended to study its tendency to further decrease.
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