Published in:
01-11-2003 | Clinical commentary
Is there a role for dehydroepiandrosterone replacement in the intensive care population?
Author:
Ketan K. Dhatariya
Published in:
Intensive Care Medicine
|
Issue 11/2003
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Excerpt
Adrenal insufficiency in the intensive care population is becoming recognised as a cause of the increased morbidity and mortality seen in these patients. However, currently there is no consensus as to what constitutes 'adrenal insufficiency' in critically ill patients. Most authors agree that the condition is diagnosed by the lack of an appropriate rise in circulating cortisol after adrenal stimulation with an intravenous bolus of synthetic adrenocorticotrophic hormone (ACTH). However, there remain controversies over what dose of synthetic ACTH to use (1 or 250 µg), and what should be the cut-off point in cortisol levels that definitively diagnoses someone as being hypoadrenal. …