Research article summary (published 29 Sep 2009):

Relative adrenal insufficiency.

Full Abstract

PURPOSE OF REVIEW: This article will review the clinical presentation, diagnosis, and treatment of acute adrenal insufficiency and explore the concept of 'relative adrenal insufficiency' in the critically ill. RECENT FINDINGS: Current dogma suggests that as many as 70% of patients in intensive care units with the clinical syndromes of sepsis or cardiogenic shock have 'relative adrenal insufficiency'. This article will explore how this concept came into being and why the concept has no clinical utility. SUMMARY: This article will provide an approach to critically ill patients that will identify adrenal insufficiency when it is part of the pathophysiology of a given patient and, at the same time, prevent the unnecessary treatment of critically ill patients with high doses of glucocorticoids for 'stress' when adrenal insufficiency is not a factor in the illness.

Author information

Author/s: Loriaux, Donald L (DL); Fleseriu, Maria (M);

Affiliation: Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA. loriauxl(-atsign-)ohsu.edu

Journal and publication information

Publication Type: Journal Article; Review

Journal: Current opinion in endocrinology, diabetes, and obesity (Curr Opin Endocrinol Diabetes Obes), published in England. (Language: eng)

Reference: 2009-Oct; vol 16 (issue 5) : pp 392-400

Dates: Created 2009/08/18; Completed 2009/11/13;

PMID: 19654538, status: MEDLINE (last retrieved date: 11/15/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MeSH Headings (categories) shown below.

Adrenal Glands - physiology Adrenal Insufficiency - classification; diagnosis; epidemiology; etiology Cosyntropin - therapeutic use Critical Illness - therapy

Humans Hydrocortisone - blood Pituitary-Adrenal Function Tests - methods Stress, Psychological - blood; complications; physiopathology

Note: Bold headings indicate primary MeSH headings or qualifiers.

Associated Chemicals: Cosyntropin (16960-16-0) ; Hydrocortisone (50-23-7)

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