title: [Relative adrenocortical insufficiency in intensive care patients].
abstract: Unexplained shock developed after a major vascular operation in a man aged 67 who used inhalation corticosteroids for a chronic obstructive pulmonary disease, and after pancreaticoduodenectomy in a man aged 56. Both had relative adrenocortical insufficiency, combated with corticosteroid supplementation. The condition of a relative adrenocortical insufficiency is considered to exist if a test dose of corticosteroids leads to rapid weaning from sympathicomimetics. A subnormal rise of plasma cortisol after stimulation with adrenocorticotropic hormone supports the diagnosis. Routine corticosteroid substitution in intensive care patients is inadvisable, because it enhances the risk of complications related to use of steroids.
authors.affiliation: Academisch Ziekenhuis Rotterdam-Dijkzigt.
authors.forename: S L
authors.initials: SL
authors.lastname: Buijk
authors.forename: J K
authors.initials: JK
authors.lastname: Kanhai
authors.forename: S W
authors.initials: SW
authors.lastname: Lamberts
authors.forename: H A
authors.initials: HA
authors.lastname: Bruining
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000309:Adrenal Insufficiency / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D000324:Adrenocorticotropic Hormone; D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery; D003422:Critical Care / Q000379:methods; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D010912:Pituitary-Adrenal Function Tests / Q000379:methods; D012773:Shock, Surgical / Q000209:etiology* / Q000628:therapy; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
chemical_list: D000305:Adrenal Cortex Hormones; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone
vernacular_title: Relatieve bijnierschorsinsufficiëntie bij intensive-carepatiënten.