Selected article for: "adrenal insufficiency and relative adrenal insufficiency"
Author: Pisano, Simone R. R.; Howard, Judith; Posthaus, Horst; Kovacevic, Alan; Yozova, Ivayla D.
Title: Hydrocortisone therapy in a cat with vasopressor-refractory septic shock and suspected critical illness-related corticosteroid insufficiency
  • Document date: 2017_5_31
    • ID: ud6uyxli_1
    Snippet: The syndrome of critical illness-related corticosteroid insufficiency (CIRCI), previously known as relative adrenal insufficiency, is defined as an endocrinological dysfunction in critically ill patients, resulting in inadequate cortisol activity for the existing severity of illness and leading to fluid-and vasopressor-refractory shock [1] [2] [3] . It may result from alterations in one or more levels of the hypothalamic-pituitary-adrenal (HPA) a.....
    Document: The syndrome of critical illness-related corticosteroid insufficiency (CIRCI), previously known as relative adrenal insufficiency, is defined as an endocrinological dysfunction in critically ill patients, resulting in inadequate cortisol activity for the existing severity of illness and leading to fluid-and vasopressor-refractory shock [1] [2] [3] . It may result from alterations in one or more levels of the hypothalamic-pituitary-adrenal (HPA) axis and glucocorticoid metabolism pathways or from decreased glucocorticoid receptor sensitivity and tissue response to corticosteroids [4] [5] [6] [7] [8] . However, its multifactorial pathophysiology is only partially understood, and there is no absolute consensus regarding criteria for the diagnosis of CIRCI in either human or veterinary medicine. The Surviving Sepsis Campaign recommends considering a patient to be affected by CIRCI if vasopressor-resistant shock is responsive to supplementation with hydrocortisone [9] .

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