Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling

BackgroundAdrenocorticotropic hormone (ACTH) is widely used in adrenal vein sampling (AVS) and can be administered as a bolus injection or continuous infusion. The optimal administration method has not been determined. We aimed to compare the effects of ACTH bolus with infusion on cannulation succes...

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Autores principales:	Jinbo Hu, Jiangqiong Chen, Qingfeng Cheng, Ying Jing, Jun Yang, Zhipeng Du, Ying Song, Linqiang Ma, Yi Yang, Ting Luo, Yue Wang, Qifu Li, Shumin Yang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	adrenocorticotropic hormone adrenal vein sampling primary aldosteronism adrenal hypertension Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/80e4bd64b69042d08bdc79435ae4273d
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spelling	oai:doaj.org-article:80e4bd64b69042d08bdc79435ae4273d2021-12-01T07:20:55ZComparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling1664-239210.3389/fendo.2021.784706https://doaj.org/article/80e4bd64b69042d08bdc79435ae4273d2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.784706/fullhttps://doaj.org/toc/1664-2392BackgroundAdrenocorticotropic hormone (ACTH) is widely used in adrenal vein sampling (AVS) and can be administered as a bolus injection or continuous infusion. The optimal administration method has not been determined. We aimed to compare the effects of ACTH bolus with infusion on cannulation success, lateralization assessment and adverse events (AEs).MethodsRetrospectively collected data from patients with primary aldosteronism who underwent AVS with ACTH at a tertiary hospital in China. Rate of successful cannulation, lateralization index (LI), complete biochemical remission and AEs related to AVS were analyzed.ResultsThe study included 80 patients receiving ACTH bolus and 94 receiving infusions. The rate of successful cannulation was comparable between bolus and infusion groups (75/80, 93.4% vs 88/94, 93.6%). In those with successful cannulation, the bolus group had a higher selectivity index than the infusion group, while LI [6.4(1.8-17.5) vs. 7.6(2.0-27.8), P=0.48] and rate of complete biochemical remission (43/44, 97.7% vs 53/53, 100%, P=0.45) did not significantly differ between the two groups. One in the bolus and one patient in the infusion group had adrenal vein rupture but they recovered with conservative treatment. The bolus group reported more transient AEs such as palpitation (52.9% vs 2.2%) and abdominal discomfort (40.0% vs 2.2%) than the infusion group.ConclusionsDue to their similar effects on cannulation success and lateralization, but a lower rate of transient AEs in the infusion group, the continuous infusion method should be recommended for ACTH stimulation in AVS.Jinbo HuJiangqiong ChenQingfeng ChengYing JingJun YangJun YangZhipeng DuYing SongLinqiang MaYi YangTing LuoYue WangQifu LiShumin YangFrontiers Media S.A.articleadrenocorticotropic hormoneadrenal vein samplingprimary aldosteronismadrenalhypertensionDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	adrenocorticotropic hormone adrenal vein sampling primary aldosteronism adrenal hypertension Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	adrenocorticotropic hormone adrenal vein sampling primary aldosteronism adrenal hypertension Diseases of the endocrine glands. Clinical endocrinology RC648-665 Jinbo Hu Jiangqiong Chen Qingfeng Cheng Ying Jing Jun Yang Jun Yang Zhipeng Du Ying Song Linqiang Ma Yi Yang Ting Luo Yue Wang Qifu Li Shumin Yang Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling
description	BackgroundAdrenocorticotropic hormone (ACTH) is widely used in adrenal vein sampling (AVS) and can be administered as a bolus injection or continuous infusion. The optimal administration method has not been determined. We aimed to compare the effects of ACTH bolus with infusion on cannulation success, lateralization assessment and adverse events (AEs).MethodsRetrospectively collected data from patients with primary aldosteronism who underwent AVS with ACTH at a tertiary hospital in China. Rate of successful cannulation, lateralization index (LI), complete biochemical remission and AEs related to AVS were analyzed.ResultsThe study included 80 patients receiving ACTH bolus and 94 receiving infusions. The rate of successful cannulation was comparable between bolus and infusion groups (75/80, 93.4% vs 88/94, 93.6%). In those with successful cannulation, the bolus group had a higher selectivity index than the infusion group, while LI [6.4(1.8-17.5) vs. 7.6(2.0-27.8), P=0.48] and rate of complete biochemical remission (43/44, 97.7% vs 53/53, 100%, P=0.45) did not significantly differ between the two groups. One in the bolus and one patient in the infusion group had adrenal vein rupture but they recovered with conservative treatment. The bolus group reported more transient AEs such as palpitation (52.9% vs 2.2%) and abdominal discomfort (40.0% vs 2.2%) than the infusion group.ConclusionsDue to their similar effects on cannulation success and lateralization, but a lower rate of transient AEs in the infusion group, the continuous infusion method should be recommended for ACTH stimulation in AVS.
format	article
author	Jinbo Hu Jiangqiong Chen Qingfeng Cheng Ying Jing Jun Yang Jun Yang Zhipeng Du Ying Song Linqiang Ma Yi Yang Ting Luo Yue Wang Qifu Li Shumin Yang
author_facet	Jinbo Hu Jiangqiong Chen Qingfeng Cheng Ying Jing Jun Yang Jun Yang Zhipeng Du Ying Song Linqiang Ma Yi Yang Ting Luo Yue Wang Qifu Li Shumin Yang
author_sort	Jinbo Hu
title	Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling
title_short	Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling
title_full	Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling
title_fullStr	Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling
title_full_unstemmed	Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling
title_sort	comparison of bolus and continuous infusion of adrenocorticotropic hormone during adrenal vein sampling
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/80e4bd64b69042d08bdc79435ae4273d
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Comparison of Bolus and Continuous Infusion of Adrenocorticotropic Hormone During Adrenal Vein Sampling

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