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|Type:||Artigo de periódico|
|Title:||Vasopressin serum levels in patients with severe brain lesions and in brain-dead patients|
de Castro, M
|Abstract:||Introduction: Patients with severe brain lesions (SBL) and brain-dead patients (BD) frequently present with vasopressin (AVP) secretion disorders. Objective: To evaluate AVID serum levels in SBL and BD patients. Design: Prospective, open label, observational trial. Setting: A general teaching hospital. Method: Three groups of adult subjects (age greater than or equal to 18y) of both sexes were included in this study: control group: 29 healthy volunteers; SBL group: 17 patients with Glasgow Coma Scale (GCS): less than or equal to8; and BD group: 11 brain-dead patients. Samples of venous blood were collected in the morning at rest from healthy volunteers and at 8 hourly intervals over a period of 24h from SBL and BID patients for AVP determinations. Concomitantly, some clinical and laboratorial variables were also recorded. Results: AVP serum levels (pg/ml) were [mean (SD); median]: control [2.2(1.1); 2.01; SBL [5.7(6.3); 2.9]; and BID [2.6(1.0); 2.81. AVID serum levels varied greatly in SBL patients, but without statistically significant difference in relation to the other groups (p=0.06). Hypotension (p=0.02), hypernatremia (p=0.0001), serum hyperosmolarity (p=0.0001) and urinary hypoosmolarity (p=0.003) were outstanding in BD patients when compared with SBL. Conclusions: The AVP serum levels did not demonstrate significant statistical difference between the groups, only showing a greater variability in SBL patients (manifested as serum spike levels). Hypernatremia and hyperosmolarity were present in BD patients, indicating a failure of the hypothalamic-pituitary system in AVP production and release.|
|Editor:||Assoc Arquivos De Neuro- Psiquiatria|
|Appears in Collections:||Unicamp - Artigos e Outros Documentos|
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