ABSTRACT
Critical illness-related corticosteroid insufficiency (CIRCI) is a state of systemic inflammation involving dysregulation of the hypothalamic-pituitary-adrenal axis, altered cortisol metabolism, and tissue resistance to corticosteroids. Many conditions may be associated with CIRCI, including sepsis, septic shock, acute respiratory distress syndrome, and severe community-acquired pneumonia. Recommendations and practice for diagnosing and treating this condition have evolved as information has emerged. Here, the author reviews the current thinking.
- Copyright © 2022 The Cleveland Clinic Foundation. All Rights Reserved.
- Stephen M. Pastores, MD, MACP, FCCP, FCCM⇑
- Program Director, Critical Care Medicine; Vice-Chair of Education, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center; Professor of Medicine in Anesthesiology and Medicine, Weill Cornell Medical College, New York, NY; researcher and member of guidelines committees on the use of corticosteroids in acutely ill patients
- Address:
Stephen M. Pastores, MD, MACP, FCCP, FCCM, Department of Anesthesiology and Critical Care Medicine, Memorial-Sloan Kettering Center Center, 1275 York Avenue, C-1179, New York, NY 10065; pastores{at}mskcc.org
ABSTRACT
Critical illness-related corticosteroid insufficiency (CIRCI) is a state of systemic inflammation involving dysregulation of the hypothalamic-pituitary-adrenal axis, altered cortisol metabolism, and tissue resistance to corticosteroids. Many conditions may be associated with CIRCI, including sepsis, septic shock, acute respiratory distress syndrome, and severe community-acquired pneumonia. Recommendations and practice for diagnosing and treating this condition have evolved as information has emerged. Here, the author reviews the current thinking.
- Copyright © 2022 The Cleveland Clinic Foundation. All Rights Reserved.
