Show Summary Details
Page of

Pathophysiology and management of adrenal disorders in the critically ill 

Pathophysiology and management of adrenal disorders in the critically ill
Chapter:
Pathophysiology and management of adrenal disorders in the critically ill
Author(s):

Bala Venkatesh

and Jeremy Cohen

DOI:
10.1093/med/9780199600830.003.0261
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2020. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 24 February 2020

The existence of the syndromes of relative adrenal insufficiency, or critical illness corticosteroid insufficiency, are debatable. In sepsis, there are alterations in plasma cortisol profiles, and corticotropin responsiveness with marked variability in responses between patients. It is probable that the spectrum of plasma and tissue glucocorticoid changes may represent a ‘sick euadrenal state’ analogous to the sick euthyroid state and may not reflect adrenocortical insufficiency. Treatment of acute adrenal crisis should not be delayed for the results of adrenal testing, and should consist of immediate supportive measures, fluid resuscitation, and high-dose intravenous glucocorticoid therapy. Admission to intensive care with a primary diagnosis of hyperadrenalism is uncommon. Patients usually present uncontrolled hypertension, electrolyte abnormalities or encephalopathy.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.