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Critical care clinics · Jan 2006
ReviewRelative adrenal failure in the ICU: an identifiable problem requiring treatment.
- Hélène Gonzalez, Olivier Nardi, and Djillali Annane.
- Service de Réanimation Médicale, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, 92380 Garches, France.
- Crit Care Clin. 2006 Jan 1; 22 (1): 105-18, vii.
AbstractCritically ill patients at some stage may develop adrenal insufficiency (AI). This article reviews the mechanisms, diagnosis criteria, consequences, and treatment of AI in various ICU conditions. Glucocorticoid insufficiency may be related to a decrease in glucocorticoid synthesis (ie, adrenal insufficiency) or to a reduced delivery of glucocorticoid to target tissues and cells. Diagnosis relies on clinical suspicion and ACTH test results. The length of cortisol replacement therapy should be at least 7 days and the adjunction of fludrocortisone is recommended.
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