Aortic Aneurysm, Abdominal Clinical Trial
Official title:
Improving The Assessment of Hypothalamic Pituitary Adrenal Function In Acute Stress
Cortisol deficiency is diagnosed by the adrenocorticotrophin (ACTH) stimulation test. This
test measures cortisol levels in the blood before and after giving an injection of ACTH.
Currently, the results of this test can only be reliably interpreted when it is carried out
on people in non-stressful situations. Frequently the test is carried out in hospitalized
patients in stressful situations, giving results that are hard to interpret.
Our study is to first do this test in a non-stressful situation, followed by a repeat test
in a stressful situation, to compare the results and create a set of guidelines for
interpreting the test when it is carried out in stressful situations.
This study proposes to provide the reference range of cortisol results when the ACTH
stimulation test is done under stressful conditions. This important information is currently
not available in the literature. To achieve this, we will perform the ACTH stimulation test
in a cohort of patients who are booked for elective surgery. By choosing elective surgery
patients, we afford ourselves the opportunity of performing the test once before surgery.
The test is then repeated within 12 hours of surgery. The first test will be done on an
out-patient basis under usual conditions (minimal stress) while the second will be done
under intense physical stress. The 2 sets of results will be compared and the effect of
stress on test results will be determined. For the sake of uniformity, we have chosen
patients who are booked to undergo repair of an abdominal aortic aneurysm (AAA) as our study
cohort.
The ACTH stimulation is an important test that suffers from limitations resulting from lack
of clear guidelines for the interpretation of results done under stressful conditions. This
study will thus improve the usefulness of an important tool in the evaluation of the
hypothalamic-pituitary-adrenal axis in stressed patients.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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