Mineralocorticoid deficiency in hemorrhagic shock

NIH Public Access Author Manuscript J Surg Res. Author manuscript; available in PMC 2014 May 29.

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Published in final edited form as: J Surg Res. 2013 April ; 180(2): 232–237. doi:10.1016/j.jss.2012.05.018.

Mineralocorticoid deficiency in hemorrhagic shock Nikolai S. Tolstoy, BSa, Majid Aized, MDb, Morgan P. McMonagle, MD, MBc, Daniel N. Holena, MDd, Jose L. Pascual, MD, PhDd, Seema S. Sonnad, PhDd, and Carrie A. Sims, MD, MSd,* aPenn

State Hershey College of Medicine, Hershey, Pennsylvania

bWayne cSt.

State University, Detroit, Michigan

Mary’s Hospital and Imperial Healthcare, London, UK

dHospital

of the University of Pennsylvania, The Trauma Center at Penn, Philadelphia, Pennsylvania

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Abstract Background—In the critically ill, mineralocorticoid deficiency (MD) is associated with greater disease severity, the development of acute renal insufficiency, and increased mortality. We hypothesized that severely injured trauma patients presenting with hemorrhagic shock would demonstrate a high degree of MD. We also hypothesized that MD in these patients would be associated with increased length of stay, hypotension, fluid requirements, and acute kidney injury (AKI). Materials and methods—Thirty-two trauma patients in hemorrhagic shock on admission to the trauma bay (SBP