Endocrine and metabolic issues in the management of the chronically critically ill patient.
The metabolic syndrome of chronic critical illness (CCI) consists of multisystem organ dysfunction resulting from the initial acute injury and chronic immune-neuroendocrine axis activation, adult kwashiorkor-like malnutrition, and prolonged immobilization with suppression of the PTH-vitamin D axis and hyper-resorptive metabolic bone disease. CCI patients can also present unique challenges in the management of diabetes mellitus, thyroid and adrenal diseases, electrolyte abnormalities and hypogonadism.
Division of Endocrinology, Diabetes, and Bone Disease, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA. Jmechanick@aol.com
Jeffrey I
JI
Mechanick
Elise M
EM
Brett
D000307:Adrenal Gland Diseases / Q000503:physiopathology / Q000628:therapy; D001851:Bone Diseases, Metabolic / Q000503:physiopathology; D002908:Chronic Disease; D016638:Critical Illness; D003920:Diabetes Mellitus / Q000628:therapy; D004703:Endocrine System / Q000503:physiopathology*; D006801:Humans; D006934:Hypercalcemia / Q000503:physiopathology; D008659:Metabolic Diseases / Q000503:physiopathology* / Q000628:therapy; D013959:Thyroid Diseases / Q000503:physiopathology / Q000628:therapy