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Journal of Intensive Care Medicine, Vol. 19, No. 2, 67-82 (2004)
DOI: 10.1177/0885066603259551
© 2004 SAGE Publications

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Endocrine Changes in Critical Illness

Eric S. Nylen, MD

George Washington University School of Medicine, VA Medical Center, 50 Irving St, NW, Rm GE246, Washington, DC 20422nylen4{at}aol.com

Beat Muller, MD

The homeostatic corrections that have emerged in the course of human evolution to cope with catastrophic events involve a complex multisystem endeavor, of which the endocrine contribution is an integral component. Although the repertoire of endocrine changes has been probed in some detail, discerning the vulnerabilities and failure of this system is far more challenging. The ensuing endocrine topics illustrate some of the current issues reflecting attempts to gain an improved insight and clinical outcome for critical illness.

Key Words: critical illness • cortisol • absolute hypoadrenalism • relative hypoadrenalism • cortisol replacement • stress hyperglycemia • stress metabolism • hyperglycemic therapy • nonthyroidal illness • hypothyroid • thyroid replacement • growth hormone resistance • mortality • immune effects • metabolic effects


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