The Endocrine Cutting Edge Of Critical Illness

摘要

Endocrinology and critical care medicine is a new and emerging issue facing intensive care unit (ICU) physicians. Until now, there has been no awareness of how endocrine dysfunctions can affect the natural history of several severe conditions in ICU patients, and no traditional, systematic approach to the problem. With the emergence of new knowledge as a result of both experimental and clinical evidence, it is now clear that this 'endocrine and metabolic axis' is critically involved in acute conditions and is a major factor influencing disease outcome. An archetypal example is the ongoing history of adrenal insufficiency in sepsis, which has initiated a novel field for steroid support yet still remains a matter of open debate as to diagnostic issues and therapeutic modalities (see review by Polito et al.). Other concurrent fields remain descriptive and do not clearly delineate obvious therapeutic recommendations for humans per se.