The integration of endocrinology into critical illness generated important new insights into the complex and constantly changing metabolic/endocrine environment accompanying severe illness. These studies uncovered endocrine biomarkers of illness severity, identified harbingers of incipient recovery and documented the effects of hormonal interventions. Developments in intensive care medicine have enabled patients to survive conditions for which natural pathophysiological coping mechanisms do not exist. These highly technological interventions in the natural process of dying have unmasked previously unknown conditions such as non-specific wasting syndrome, hyperglycemia and insulin resistance, atrophy of intestinal mucosa and disturbed motility of thegastrointestinal tract, all of which contribute to the protracted dependency on intensive care support. This review will provide an up to date overview of the current knowledge. It is hoped that this would stimulate further interdisciplinary research into this important and exciting field.
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