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Master Thesis

Volume des glandes surrénaliennes à l’admission et défaillance d’organe à 24h chez les patients traumatisés en choc hémorragique

Abstract : Adrenal gland volume on admission and organ failure at 24 hours in trauma patients in hemorrhagic shock Background : Adrenal axis is a major component of the physiological response during shock. The aim of this study was to describe the adrenal volume (AV) and its possible association with organ failure at 24 hours in severe trauma patients in hemorrhagic shock. Methods : This is an observational, two-center study including all patients admitted for suspected severe trauma (ST). Patients with initial Glasgow score less than 9 were excluded. The measurement of AV (total and size indexed) was performed by a blinded radiologist. Patients were classified into 3 groups : severe trauma with hemorrhagic shock (STHC) defined by an Injury Severity Score (ISS) > 15 and transfusion = 4 red cells in less than 6 hours associated with hypotension (systolic blood pressure < 90 mmHg), ST defined by an ISS > 15 without hemorrhagic shock and control (C) defined by ISS <16 without shock. The 3 groups were matched for age and sex. Results : 263 patients were included (STHC : n = 84, ST : n = 89, C : n = 90). SOFA at 24 hours STHC groups, ST and C were respectively 9 [7, 12], 2 [0, 5], and 0 [0, 1] (p <0.001). AV (total and indexed) were not different in the 3 groups (p = 0.9 and 0.66). There was no correlation between total and indexed AV on admission and SOFA at 24 hours (r2 = 0.04 for AV and r2 = - 0.05 for size indexed AV). Conclusion : The presence of hemorrhagic shock in the ST does not appear associated with early adrenal volume change and does not seem to correlate with clinical severity in 24 hours.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01230576
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Submitted on : Wednesday, November 18, 2015 - 3:56:39 PM
Last modification on : Friday, March 27, 2020 - 2:26:12 AM
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  • HAL Id : dumas-01230576, version 1

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Denis Lemesle. Volume des glandes surrénaliennes à l’admission et défaillance d’organe à 24h chez les patients traumatisés en choc hémorragique. Médecine humaine et pathologie. 2015. ⟨dumas-01230576⟩

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