caa a22 4500 445373571 CHVBK 20180317142955.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00540-011-1118-3 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1118-3 Catecholamine-resistant shock and hypoglycemic coma after cardiotomy in a patient with unexpected isolated ACTH deficiency [Elektronische Daten] [Shigekiyo Matsumoto, Satoshi Hagiwara, Junya Kusaka, Rie Hasegawa, Hitomi Nonaka, Chihiro Shingu, Takayuki Noguchi] Isolated adrenocorticotropic hormone (ACTH) deficiency is an extremely rare disease in which ACTH-producing cells of the pituitary gland are selectively damaged. The resulting decline in ACTH production and secretion results in chronic secondary adrenocortical insufficiency. The patient in this case did not present with adrenal insufficiency symptoms prior to surgery. However, after cardiotomy under extracorporeal circulation, the patient lapsed into a catecholamine-resistant shock and hypoglycemic coma. Acute adrenal insufficiency was strongly suspected, and the patient was diagnosed with isolated ACTH deficiency after careful examination. Because the demand for cortisol increases after highly invasive surgeries, cortisol supplementation therapy is essential for patients with complications from isolated ACTH deficiency. There is a high risk of a lethal outcome when surgery is carried out without a diagnosis, as in this case. Therefore, cortisol must be supplemented without delay when acute adrenal insufficiency is suspected during the perioperative period. Japanese Society of Anesthesiologists, 2011 ACTH nationallicence Cortisol nationallicence Adrenal insufficiency nationallicence Hypoglycemia nationallicence Hypotension nationallicence Matsumoto Shigekiyo Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut Hagiwara Satoshi Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut Kusaka Junya Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut Hasegawa Rie Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut Nonaka Hitomi Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut Shingu Chihiro Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut Noguchi Takayuki Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut Journal of Anesthesia Springer Japan 25/3(2011-06-01), 431-434 0913-8668 25:3<431 2011 25 540 https://doi.org/10.1007/s00540-011-1118-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1118-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Matsumoto Shigekiyo Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut NATIONALLICENCE 700 1- Hagiwara Satoshi Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut NATIONALLICENCE 700 1- Kusaka Junya Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut NATIONALLICENCE 700 1- Hasegawa Rie Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut NATIONALLICENCE 700 1- Nonaka Hitomi Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut NATIONALLICENCE 700 1- Shingu Chihiro Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut NATIONALLICENCE 700 1- Noguchi Takayuki Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, 879-5593, Yufu, Oita, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/3(2011-06-01), 431-434 0913-8668 25:3<431 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer