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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
2003-11-25
pubmed:abstractText
We report the results of a prospective randomized controlled trial, which looked at the incidence of postoperative diabetes insipidus (DI) following the use of three different hydrocortisone protocols, and the results of a study, on the incidence of DI and cortisol response in patients not given hydrocortisone. In study 1, 114 patients with pituitary macroadenoma were randomized into three groups: conventional dose (inj. hydrocortisone 100 mg IV 6-hourly for 3 days); intermediate dose (inj. hydrocortisone 100 mg IV 6-hourly on day 1, 100 mg IV 8-hourly on day 2, and 100 mg IV 12-hourly on day 3); low dose protocol (inj. hydrocortisone 25 mg IV 6-hourly on day 1, 25 mg IV 8-hourly on day 2 and 25 mg IV 12-hourly on day 3). Radical excision was achieved in 92 patients. The incidence of DI with the conventional dose was 52%, intermediate dose, 36% and low dose, 24% (p = 0.025). Study 2 included 16 consecutive patients with Hardy's grade A & B pituitary adenoma. These patients were randomized to receive (Group I) or not receive (Group II) hydrocortisone. Patients in Group II demonstrated normal cortisol response intraoperatively and no patient developed features of hypocortisolism; the incidence of DI in this group was 14%. The low dose hydrocortisone protocol reduced the incidence of DI by 46% when compared with the conventional dose hydrocortisone protocol. In patients with grade A and B tumour with normal preoperative cortisol levels, the use of perioperative hydrocortisone can be avoided.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
0268-8697
pubmed:author
pubmed:issnType
Print
pubmed:volume
17
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
437-42
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:14635749-Adenoma, pubmed-meshheading:14635749-Adolescent, pubmed-meshheading:14635749-Adult, pubmed-meshheading:14635749-Anti-Inflammatory Agents, pubmed-meshheading:14635749-Diabetes Insipidus, pubmed-meshheading:14635749-Dose-Response Relationship, Drug, pubmed-meshheading:14635749-Drug Administration Schedule, pubmed-meshheading:14635749-Female, pubmed-meshheading:14635749-Humans, pubmed-meshheading:14635749-Hydrocortisone, pubmed-meshheading:14635749-Injections, Intravenous, pubmed-meshheading:14635749-Male, pubmed-meshheading:14635749-Middle Aged, pubmed-meshheading:14635749-Neurosurgical Procedures, pubmed-meshheading:14635749-Pituitary Gland, pubmed-meshheading:14635749-Pituitary Neoplasms, pubmed-meshheading:14635749-Postoperative Complications, pubmed-meshheading:14635749-Prospective Studies
pubmed:year
2003
pubmed:articleTitle
Hydrocortisone dose and postoperative diabetes insipidus in patients undergoing transsphenoidal pituitary surgery: a prospective randomized controlled study.
pubmed:affiliation
Department of Endocrinology, Christian Medical College, Vellore, India. simonraj@cmcvellore.ac.in
pubmed:publicationType
Journal Article, Clinical Trial, Randomized Controlled Trial