Corticosteroid insufficiency in acutely ill patients.
نویسندگان
چکیده
N Engl J Med 2003;348:727-34. Copyright © 2003 Massachusetts Medical Society. n increase in tissue corticosteroid levels during acute illness is an important protective response. Many diseases and their treatments interfere with the normal corticosteroid response to illness and thus induce tissue corticosteroid insufficiency. In this article, we review the physiology of the corticosteroid response to acute illness, describe the clinical features of hypoadrenalism in patients with acute illness, and discuss practical issues relating to diagnosis and treatment of corticosteroid insufficiency in acutely ill patients.
منابع مشابه
Indications and practical use of replacement dose of corticosteroids in critical illness.
PURPOSE OF REVIEW Ongoing and severe systemic inflammation affecting critically ill patients may cause adrenal insufficiency and steroid resistance in target cells. As the appropriate diagnosis of this clinical entity remains a challenge, indication and practical use of corticosteroid replacement therapy in the critically ill is generally directed by clinical symptoms and features. RECENT FIN...
متن کاملMechanisms and clinical consequences of critical illness associated adrenal insufficiency.
PURPOSE OF REVIEW Adrenal insufficiency is being diagnosed with increasing frequency in critically ill patients. There exists, however, much controversy in the literature as to the nature of this entity, including its pathophysiology, epidemiology, diagnosis and treatment. The review summarizes our current understanding of the causes and consequences of adrenal insufficiency in critically ill p...
متن کاملRecommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients: consensus statements from an international task force by the American College of Critical Care Medicine.
OBJECTIVE To develop consensus statements for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients. PARTICIPANTS A multidisciplinary, multispecialty task force of experts in critical care medicine was convened from the membership of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. In addition, international exp...
متن کاملPrevention of venous thromboembolism in hospitalized acutely ill medical patients: focus on the clinical utility of (low-dose) fondaparinux
Venous thromboembolism (VTE) is a frequent complication among acutely ill medical patients hospitalized for congestive heart failure, acute respiratory insufficiency, rheumatologic disorders, and acute infectious and/or inflammatory diseases. Based on robust data from randomized controlled studies and meta-analyses showing a reduced incidence of VTE by 40% to about 60% with pharmacologic thromb...
متن کاملCritical illness-related corticosteroid insufficiency in children.
Adequate adrenocortical function is essential for survival in critical illness. Most critically ill patients display elevated plasma cortisol concentrations, which reflects activation of the hypothalamic-pituitary-adrenal axis and is considered to be a homeostatic adaptation. However, many critically ill patients have 'relative' or 'functional' adrenal insufficiency, which is characterized by a...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The New England journal of medicine
دوره 348 21 شماره
صفحات -
تاریخ انتشار 2003