Adrenal insufficiency in the surgical intensive care unit patient.
Annual Meeting of the Eastern Association for the Surgery of Trauma. Orlando, Florida (USA), 1996/01/10.
Adrenocortical dysfunction is unusual in the unselected critically ill patient.
Case reports document a state of corticosteroid responsive vasopressor dependence, resembling the systemic inflammatory response syndrome.
The exact incidence of this disorder is unknown.
We prospectively studied the incidence of adrenal insufficiency during a 9-month period in a surgical intensive care unit (ICU) population.
Trauma, general surgery, urology, and gynecologic-oncology patients were included.
Patients who met criteria were given a cosyntropin stimulation test.
Overall, the incidence of adrenal insufficiency was 0.66%. In the subgroup of patients with greater than 14 days stay in the ICU, 6% were found to have adrenal insufficiency.
In patients aged more than 55 years and with ICU stays of 14 days or greater, 11% were adrenally insufficient.
Screening of critically ill patients for adrenal insufficiency, particularly those with prolonged ICU stay and age greater than 55 years, is warranted.
Mots-clés Pascal : Insuffisance surrénalienne, Chirurgie, Unité soin intensif, Analyse biochimique, Stimulation, Tétracosactide, Diagnostic, Etude longitudinale, Homme, Epidémiologie, Endocrinopathie, Surrénale pathologie
Mots-clés Pascal anglais : Adrenal insufficiency, Surgery, Intensive care unit, Biochemical analysis, Stimulation, Tetracosactide, Diagnosis, Follow up study, Human, Epidemiology, Endocrinopathy, Adrenal gland diseases
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0147982
Code Inist : 002B21B01. Création : 21/05/1997.