Relative adrenal insufficiency in the intensive care population; background and critical appraisal of the evidence

25Citations
Citations of this article
25Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Dysfunction of the hypothalamo-pituitary adrenal axis has become a central feature in descriptions of the pathophysiology of sepsis. However, despite hundreds of published articles including literature reviews and consensus statements, controversy still exists regarding the fundamental nature of the disorder and its relevance to clinical management. Often referred to as 'relative adrenal insufficiency', a recent consensus conference has proposed the alternate term 'critical illness related corticosteroid insufficiency' and suggested diagnostic criteria of a delta serum cortisol of less than 9 μg/l after adrenocorticotrophic hormone administration or a random total cortisol of under 10 μg/l. This review attempts to establish a critical reappraisal of the evidence for the existence of relative adrenal insufficiency/critical illness related corticosteroid insufficiency in patients with sepsis and examines the background, controversies and possibilities for future research into the condition.

Cite

CITATION STYLE

APA

Cohen, J., & Venkatesh, B. (2010). Relative adrenal insufficiency in the intensive care population; background and critical appraisal of the evidence. Anaesthesia and Intensive Care. Australian Society of Anaesthetists. https://doi.org/10.1177/0310057x1003800304

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free