Patients Who Fainted Whilst Giving a Blood Sample in the Blood Collectıon Unit and a Stress Mediator: Cortisol Kan Alma Ünitesinde Kan Örneği Verirken Bayılan Hastalar ve Bir Stress Medyatörü: Kortizol
Genel Tip Dergisi, cilt.32, sa.6, ss.666-669, 2022 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 6
- Basım Tarihi: 2022
- Doi Numarası: 10.54005/geneltip.1136552
- Dergi Adı: Genel Tip Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.666-669
- Anahtar Kelimeler: Adrenal Insufficiency, cortisol, Syncope
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Serum cortisol is a glucocorticoid and can be used as a stress mediator in association with adrenal insufficiency. A diagnosis of adrenal insufficiency is made when the episodically released serum cortisol levels are below 3 mcg/dl by making a single measurement at any time of the day. In this study, we aimed to define the presence of underlying adrenal insufficiency by measuring serum cortisol levels in patients who fainted while giving blood samples in the blood collection unit and brought to the emergency room by the hospital code blue team after receiving critical care. Materials and Methods: Observational, prospective study; It consists of 28 patients brought to emergency department by Code Blue Team between 2017 and 2020. After physical examination and electrocardiogram(ECG) evaluation, samples were taken for complete blood count, biochemical parameters, venous blood gas, cardiac biomarkers and serum cortisol measurement. Blood samples taken at the time of application were studied in the emergency laboratory on the same day. Obtained results were analyzed with SPSS 22 and MATLAB programs. Results: The lowest serum serum cortisol level was 9 mcg/dL, and the highest serum cortisol level was 40,4 mcg/dL. Serum cortisol levels were higher in females than males. To evaluate statistically difference between serum cortisol values of male and female, t-test was applied. The test results revealed that gender is not a determining factor in serum cortisol levels (p=0,26). Moreover, correlation analysis was performed to determine strength of the relationship and Pearson correlation was calculated (r=0.314). Statistical analysis indicated that the correlation coefficient is not statistically significant at the 95% confidence level. The patient diagnosed with adrenal insufficiency with a single measurement was not defined in the study population. Conclusions: Patients with acute adrenal insufficiency may come to the emergency department with orthostatic hypotension, agitation, syncope, abdominal pain and fever, and may result in death if it is left untreated. When the serum cortisol levels of the patients who experienced intense stress during blood sampling and had syncope were examined within the scope of the study, a critical value that would make the diagnosis of adrenal insufficiency was not found. Although emotional stress is 20% among the precipitating factors of adrenal crisis, no significant relationship was found between stress and serum cortisol in our study. The limitations of our study are that it can only be carried out during working hours 08:00-16:00, and advanced diagnostic tests for primary and/or secondary adrenal insufficiency can not be performed in the emergency room.