Study of serum testosterone as a prognostic indicator in patients with respiratory failure on mechanical ventilation

Abstract

Patients on mechanical ventilation tend to have a multitude of biochemical changes, many due to adrenal suppression or functional adrenal insufficiency Abnormal levels of gonadal steroids poses significant physiologic effects in critically ill patients. Hypotestosteronemia, defined as a serum total testosterone level <250 ng/dL (<8.7 nmol/L) or free testosterone level <0.75 ng/dL (<0.03 nmol/L), is a common finding among male patients with critical illness. In this this study we determine if serum testosterone can be used as a prognostic indicator in patients with respiratory failure, on mechanical ventilation. This is a prospective observational study done over a period of 18 months at a tertiary care canter in Mysore. Study participants included male patients admitted to ICU of JSS Hospital with documented acute respiratory failure on arterial blood gas analysis (ABG), who were mechanically ventilated for more than 24 hours. Blood sample was collected at 24 hours and 72 hours post intubation and serum testosterone levels were estimated using Electro Chemiluminescence assay. Our results indicate 90.5% of the patients had low testosterone levels at 24 hours, whereas 97.1% of the patients had hypotestosteronemia at 72 hours post intubation.