CORTISOL AND CATECHOLAMINE KINETICS DURING CONTINUOUS HEMODIAFILTRATION IN PATIENTS WITH MULTIPLE ORGAN DYSFUNCTION SYNDROME

Objective: To assess the influence of continuous hemodiafiltration (CH DF) on cortisol and catecholamine kinetics in multiple organ dysfuncti on syndrome. Design: Consecutive clinical study. Setting. General inte nsive care unit of a university hospital. Patients: Ten adult patients with multiple organ dysfunction syndrome requiring CHDF. Measurements and results: A total of 40 samples were collected during CHDF for cor tisol and catecholamine assays. The clearances for cortisol, epinephri ne, norepinephrine and dopamine were 2.5 +/- 1.7 ml/min, 26.3 +/- 2.7 ml/min, 16.7 +/- 4.2 ml/min and 26.3 +/- 2.6 ml/min (Mean +/- SE), and their daily extractions were 1.8 +/- 0.2 mg/day, 11.4 +/- 4.8 mu g/da y, 1.0 +/- 0.1 mu g and 2.3 +/- 0.3 mu g/day, respectively. There were no significant changes in blood cortisol and catecholamine levels dur ing CHDF conducted for 48 h. Conclusions: The cortisol and catecholami ne losses during CHDF were small and unlikely to lead to hemodynamic d isturbances.