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  • Title: Beta-endorphin and catecholamine concentrations during chronic and acute stress in intensive care patients.
    Author: Schmidt C, Kraft K.
    Journal: Eur J Med Res; 1996 Sep 20; 1(11):528-32. PubMed ID: 9438155.
    Abstract:
    BACKGROUND: Only little information is available on the effects of acute and chronic stress on the opioid and adrenergic systems in patients at intensive care units. Animal models showed a stimulation of beta-endorphin and catecholamines. METHODS: In the present study, in 12 patients who were intubated and were receiving artificial respiration because of cardiopulmonary resuscitation or primary respiratory failure, venous plasma concentrations of adrenaline, noradrenaline and beta-endorphin immuno-reactive material (IRM) were determined by a radioimmunoassay. In these patients, regular endobronchial suctioning was necessary. For inducing acute stress patients underwent three different methods of endobronchial suctioning or lavage. RESULTS: In all patients concentrations of both adrenaline (529 +/- 117 pg/ml) and noradrenaline (2694 +/- 262 pg/ml) were increased above normal resting values. In 5 patients plasma beta-endorphin IRM concentration was below the detection limit, the other patients had beta-endorphin IRM concentrations above normal (26.65 +/- 3.80 pg/ml). Epinephrine (227 +/- 33 vs. 743 +/- 189 pg/ml; p < 0.01) and norepinephrine (1673 +/- 161 vs. 3423 +/- 368 pg/ml; p < 0.001) were significantly lower in the group with undetectable beta-endorphin IRM concentrations than in the group with detectable beta-endorphin IRM whereas heart rate was significantly higher (120/min vs. 99/min; p < 0.0003). beta-endorphin IRM concentrations were correlated negatively to heart rate (-0.55; p < 0.0005) and positively to the noradrenaline concentration (0.56; p < 0.0004). Artificially ventilated patients showed increased levels of beta-endorphin (19.27 +/- 3.16 pg/ml) as compared to the spontaneously breathing patients (13.29 +/- 4.34 pg/ml). Following acute stress due to endobronchial suctioning or lavage, blood pressure (150/70 mmHg vs. 172/81 mmHg; p < 0.01) and heart rate (107/min vs. 119/min; p < 0.005) increased in all patients, the other parameters did not. CONCLUSION: It is concluded that beta-endorphin IRM concentration in the plasma is linked to epinephrine and norepinephrine concentrations under intensive care conditions. Endobronchial lavage or suctioning does not influence beta-endorphin IRM levels in plasma.
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