How to manage perioperative endocrine insufficiency.
Patients with endocrinopathies frequently present to the operating room. Although many of these disorders are managed on a chronic basis, patients may have acute changes in the perioperative period that, if left unrecognized, can have a negative effect on perioperative morbidity and mortality. It is imperative that anesthesiologists understand the implications of the surgical stress response on hormonal flux. This article focuses on the 4 most commonly encountered endocrinopathies: diabetes mellitus, hyperthyroidism, hypothyroidism, and adrenal insufficiency. Specific challenges pertaining to patients with pheochromocytoma are also discussed.
Kohl
Benjamin A
BA
Department of Anesthesiology and Critical Care, University of Pennsylvania School of Medicine, 3400 Spruce Street, Dulles Building, Suite 680, Philadelphia, PA 19104, USA. Benjamin.Kohl@uphs.upenn.edu
Schwartz
Stanley
S
D000310:Adrenal Gland Neoplasms / Q000150:complications; D000309:Adrenal Insufficiency / Q000150:complications; D000758:Anesthesia; D003920:Diabetes Mellitus / Q000628:therapy; D004700:Endocrine System Diseases / Q000628:therapy*; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications; D007037:Hypothyroidism / Q000150:complications; D019990:Perioperative Care; D010673:Pheochromocytoma / Q000150:complications