Critical illness-related corticosteroid insufficiency in patients after cardiac surgery and cardiologic emergencies

Abstract

Critical illness-related corticosteroid insufficiency (CIRCI) is associated with elevated level of circulating biomarkers of inflammation, procoagulant effects, deterioration of systemic inflammatory response syndrome (SIRS) and, consequently, prolonged in-hospital stay and increased mortality of intensive care patients. Incidence of CIRCI widely varies depending on specific patient's population and applied diagnostic thresholds being as high as 30% among postoperative patients on inotropes. CIRCI is a complex clinical and pathophysiological condition with substantial influence on immediate survival and prognosis. Clinical impact of CIRCI as well as pathogenetically based therapy arouse keen interest of intensive care specialists and clinical pathologists. The specific issues of CIRCI in patients after cardiac surgery and cardiology emergencies remain largely under-recognized, so further scrutinization is needed.