AAP Grand Rounds 14:39-40 (2005)
© 2005 American Academy of Pediatrics
CRITICAL CARE
Adrenal Insufficiency in Septic Shock
Source: Pizarro CF, Troster EJ, Damiani D, et al. Absolute and relative adrenal insufficiency in children with septic shock. Crit Care Med. 2005;33:855–859.[Medline]
| The first 20% of the full text of this article appears below. |
The authors from the University of Medicine in Sao Paulo, Brazil, studied 57 children with clinical diagnoses of septic shock. Patients were excluded if they had received steroids or etomidate in the week before development of shock. Eligible patients were children with suspected infection with hypothermia/hyperthermia, signs of poor perfusion, or poor urine output. Hypotension was not required. The severity of shock was classified as fluid-responsive, fluid-refractory (shock that was reversed by 60 mL/kg fluid resuscitation and dopamine or dobutamine 
10 µg/kg per minute), or catecholamine-resistant shock (shock that persisted despite administration of epinephrine or nor-epinephrine). Patients were evaluated with baseline cortisol levels and their responses after 30 minutes and 60 minutes to 250 µg of corticotrophin. Absolute adrenal insufficiency was defined as a baseline cortisol level <20 µg/dL and an incremental increase of 9 . . . [Full Text of this Article]
Susan L. Bratton, MD, MPH, FAAP
|
Pediatric Critical Care, Primary Children’s Medical Center, University of Utah Health Science Center, Salt Lake City, UT
|
Copyright © 2005 by the American Academy of Pediatrics.
