Hemodynamic instability secondary to adrenal insufficiency in a major burn patient.
A 39-year-old man presented with 80% body surface area burned following a thermal accident. The patient showed hemodynamic instability and low response to intravenous fluids or vasopressors for 20 days in the intensive care unit (ICU). The adrenocorticotropic hormone (ACTH) test was consistent with adrenal insufficiency. After a 3-day steroid treatment, the patient's blood pressure was normal without the administration of any vasopressor.
Nácul
Flávio E
FE
Clínica São Vicente, Intensive Care Unit, RJ, Rio de Janeiro, Brazil. fnacul@svgavea.com.br
Jardim
Allex
A
MacCord
Flávio
F
Penido
Carmen
C
Gomes
Marcelo V
MV
D000304:Adrenal Cortex Function Tests; D000309:Adrenal Insufficiency / Q000209:etiology*; D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use*; D000328:Adult; D002056:Burns / Q000150:complications* / Q000628:therapy; D005440:Fluid Therapy; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D008297:Male; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014945:Wound Healing
D014662:Vasoconstrictor Agents; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone