Corticosteroid insufficiency in acutely ill patients
Abstract
Recent studies report benefits from corticosteroid treatment in patients with septic shock. This review summarizes the physiology of the corticosteroid response in acute illness. The authors present an updated, practical approach to the diagnosis and treatment of hypoadrenalism in acutely ill patients. Supplemental corticosteroid treatment may be beneficial in many critical illnesses.
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An acute-phase cortisol level below 300 nmol/l is suggestive of adrenal insufficiency.
“An acute-phase cortisol level below 300 nmol/l is suggestive of adrenal insufficiency (34)”
From Post-Traumatic Hypopituitarism—Who Should Be Screened, When, and How? (2018) · cites this paper as [34]
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References 55 · Cited by 1,033
- Authors
- Cooper, M. S., & Stewart, P. M.
- Affiliations
- University of Birmingham (GB)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2003-02-20
- Volume
- 348
- Issue
- 8
- Pages
- 727-734
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2126105025
- Cited by
- 1,033
- References
- 55
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 18 · 2023: 19 · 2022: 23 · 2021: 26 · 2020: 31 · 2019: 24 · 2018: 29 · 2017: 36 · 2016: 37 · 2015: 43 · 2014: 51 · 2013: 34 · 2012: 68
- FWCI
- 13.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Keywords
- corticosteroid insufficiency, adrenal insufficiency, septic shock, acute illness, adrenal insufficiency diagnosis, critical illness, stress response
- MeSH terms
- Acute Disease, Adrenal Cortex Hormones, Adrenal Insufficiency, Cosyntropin, Glucocorticoids, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Shock, Septic, Critical Illness
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