Adrenal insufficiency related to critical illness is a serious condition characterized by an elevated heart rate, low blood pressure, and a lack of response to fluid and inotrope therapy. Adrenal insufficiency results from an inadequate level of cortisol (the body’s intrinsic corticosteroid) to deal with critical illness. Many clinicians believe that corticosteroids improve outcomes in such patients. However, the effectiveness and safety of steroid replacement therapy in this population remain to be demonstrated. The PICU research group is conducting a multi-stage research program to address this issue, with an end goal of developing evidence based guidelines to optimize the care provided to critically ill children.
Adrenal suppression from glucocorticoids: preventing an iatrogenic cause of morbidity and mortality in children
The intent of this review is to draw attention to this important entity and to allow the reader to create an informed and practical approach to the management of their patients at risk.
Evaluating the Low-Dose ACTH Stimulation Test in Children: Ideal Times for Cortisol Measurement
To determine optimal times to draw cortisol levels and factors predicting timing of peak cortisol levels in children undergoing LDST.