Background: Simultaneous bilateral petrosal sinus sampling is valuable in differentiating the etiology of ACTH dependent Cushings syndrome. It is used to locate the source of ACTH production when pituitary magnetic resonance imaging is negative.
Nurses role: Specially trained endocrine nurses are part of the team for inferior petrosal sinus sampling. They prepare necessary material and documentation, mark all test tubes, handle the samples taken from both catheters record the time and localization of each sample, take samples from the peripheral vein, give iv bolus of CRH and keep track of time for sampling after CRH administration. Nurses are also responsible for adequate and timely transportation of samples for ACTH (on ice) and cortisol measurement to laboratory and proper material submission to the lab. They prepare patient for the procedure and monitor him/her through and after the procedure.
Aim: To analyze results of all bilateral inferior petrosal venous sampling studies performed in our center during period 2009/2010.
Patients and methods: In six patients with ACTH dependent Cushings syndrome BIPSS was performed. Patients records, catheter and laboratory protocols were analyzed retrospectively for the period 2009/2010.
Results: During 2009/2010 period 7 studies were performed in our (tertiary) center. In all 7 cases simultaneous bilateral petrosal venous sampling with CRH administration was performed. In two patients whole body venous sampling was performed disclosing the ectopic source of ACTH secretion in one patient. In two patients unilateral venous malformations were encountered and samples were taken from the inferior jugular vein. In one patient results were inconclusive and study was repeated. In 5 cases results of the catheter study confirmed the diagnosis of Cushings disease.
Conclusion: Role of endocrine nurse in coordination with other members of the team is important for the success of catheter studies in patients with Cushings syndrome.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
05 - 09 May 2012
European Society of Endocrinology