The effect of phlebotomy and placement of an intravenous catheter on plasma catecholamine and serum copeptin concentrations.

IF 1.3 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM
Shruti Sastry, Emir Tas, Domenic Filingeri, Erika McCann, Rahul Amruthapuri, Michael J McPhaul, Luigi Garibaldi
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引用次数: 0

Abstract

Objectives: Limited data are available on the hormonal response of children to venepuncture or intravenous cannulation (IVC). Catecholamines (epinephrine (E) and norepinephrine (NE)) have been traditionally recognized as stress hormones. Copeptin, the carboxyl-terminus of the arginine vasopressin (AVP) precursor peptide, is also a known marker for stressful stimuli, including myocardial infarction, critical illness, and sepsis. We aimed to measure the above stress markers in response to IVC in the pediatric population.

Methods: We measured plasma E, NE and serum copeptin concentrations in 100 children aged 5-17 years undergoing endocrine testing. Labs were drawn 1-3 min (min) after placement of IV cannula (baseline or 0 min) and then re-measured 20 min later (+20 min) while subjects rested in a quiet room.

Results: Between 0 and 20 min, the median (IQR) NE (n=99) changed from 349 (244, 482) pg/mL to 253 (184, 348) pg/mL (p<0.001); E (n=54) changed from 57 (43, 116) pg/mL to 57 (38, 96) pg/mL (p=0.024); Copeptin changed from 9.4 (6.3, 15.2) pmol/L to 9 (5, 13) pmol/L (p<0.001). The mean decrease (delta) was 106 pg/mL for NE (28 %, p<0.001), 16 pg/mL for E (18 %, p=0.042) and 2.7 pmol/L for copeptin (17 %, p=0.012). There was no correlation between the decrease (expressed as a percentage) in NE vs. E, E vs. copeptin, and NE vs. copeptin.

Conclusions: Our data suggest that the stress of IVC induces a rapid increase in NE, E, as previously described, as well as copeptin levels. The copeptin decrement, concordant with the catecholamine trend in the minutes after IVC, supports this peptide (and AVP) as a rapid response marker of stress, and has unclear practical implications for copeptin measurements in evaluating fluid and sodium metabolism disorders in children.

放血和静脉置管对血浆儿茶酚胺和血清copeptin浓度的影响。
目的:关于儿童静脉穿刺或静脉插管(IVC)的激素反应的数据有限。儿茶酚胺[肾上腺素(E)和去甲肾上腺素(NE)]历来被认为是应激激素。Copeptin是精氨酸抗利尿素(AVP)前体肽的羧基末端,也是一种已知的应激刺激标志物,包括心肌梗死、危重疾病和败血症。我们的目的是在儿科人群中测量上述应激标志物对IVC的反应。方法:测定100例5 ~ 17岁儿童的血浆E、NE和血清copeptin浓度。静脉插管后1-3 min (min)(基线或0 min)抽取实验室,20 min(+20 min)后重新测量,受试者在安静的房间休息。结果:在0到20 min之间,中位(IQR) NE (n=99)从349 (244,482)pg/mL变化到253 (184,348)pg/mL(结论:我们的数据表明,IVC应激诱导NE、E以及copeptin水平快速增加,如前所述。copeptin的减少与儿茶酚胺在IVC后几分钟内的趋势一致,支持该肽(和AVP)作为应激的快速反应标志物,并对copeptin测量在评估儿童液体和钠代谢紊乱中的实际意义尚不清楚。
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来源期刊
CiteScore
2.70
自引率
7.10%
发文量
176
审稿时长
3-6 weeks
期刊介绍: The aim of the Journal of Pediatric Endocrinology and Metabolism (JPEM) is to diffuse speedily new medical information by publishing clinical investigations in pediatric endocrinology and basic research from all over the world. JPEM is the only international journal dedicated exclusively to endocrinology in the neonatal, pediatric and adolescent age groups. JPEM is a high-quality journal dedicated to pediatric endocrinology in its broadest sense, which is needed at this time of rapid expansion of the field of endocrinology. JPEM publishes Reviews, Original Research, Case Reports, Short Communications and Letters to the Editor (including comments on published papers),. JPEM publishes supplements of proceedings and abstracts of pediatric endocrinology and diabetes society meetings.
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