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  • Print publication year: 2010
  • Online publication date: July 2010

Chapter 15 - Glucocorticoids in the critically ill

from Section 3 - Endocrine disorders in the critically ill

Summary

The International Diabetes Federation estimated that in 2008 there were 246 million adults worldwide with diabetes mellitus (DM), and the prevalence is expected to reach at least 380 million by 2025. Diabetes is diagnosed on the basis of criteria agreed by the World Health Organization (WHO) in 1999. Destruction of the pancreatic ß-cells is characteristic of type 1 DM and usually results in an absolute deficiency of insulin. The principles of management of type 1 DM are based on the detailed observations made in two major trials; the Diabetes Control and Complications Trial (DCCT) and the subsequent Epidemiology of Diabetes Interventions and Complications study (EDIC). Hypoglycaemia is a major concern for many type 1 diabetic patients and is usually described as mild, moderate or severe. Most of the increased morbidity and mortality associated with DM is the result of the micro- and macrovascular complications.

References

1. ChinR, EagertonDC, SalemM. Corticosteroids. In ChernowB, BraterDC, eds. The Pharmacologic Approach to the Critically Ill Patient, 3rd edn. Williams and Wilkins, Baltimore, 1994, pp. 715–41.
2. CzockD, KellerF, RascheFM, et al. Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids. Clin Pharmacokinet 2006; 44: 61–98.
3. BarnesPJ. How corticosteroids control inflammation: Quintiles prize lecture 2005. Br J Pharmacol 2006; 148: 245–54.
4. BuckinghamJC. Glucocorticoids: exemplars of multi-tasking. Br J Pharmacol 2006; 147: S258–68.
5. RadyMY, JohnsonDJ, PatelB, et al. Corticosteroids influence the mortality and morbidity of acute critical illness. Crit Care 2006; 10: R101.
6. CoursinDB, WoodKE. Corticosteroid supplementation for adrenal insufficiency. JAMA 2002; 287: 236–40.
7. OelkersW. Adrenal insufficiency. N Engl J Med 1996; 335: 1206–12.
8. CooperMS, StewartPM. Corticosteroid insufficiency in acutely ill patients. N Engl J Med 2003; 348: 727–34.
9. LambertsSWJ, BruiningHA, De JongFH. Corticosteroid therapy in severe illness. N Engl J Med 1997; 337: 1285–92.
10. Lipiner-FriedmanD, SprungCL, LaterrePF, et al. Adrenal function in sepsis: The retrospective CORTICUS cohort study. Crit Care Med 2007; 35: 1012–18.
11. CooperMS, StewartPM. Adrenal insufficiency in critical illness. J Intensive Care Med 2007; 22: 348–62.
12. BouachourG, TirotP, GouelloJP, et al. Adrenocortical function during septic shock. Intensive Care Med 1995; 21: 57–62.
13. AnnaneD, SebilleV, TrocheG, et al. A three-level prognostic classification in septic shock based on cortisol levels and cortisol response to corticotrophin. JAMA 2000; 283: 1038–45.
14. MarikPE, ZalogaGP. Adrenal insufficiency during septic shock. Crit Care Med 2003; 31: 141–5.
15. ArafahBM. Hypothalamic pituitary adrenal function during critical illness: Limitations of current assessment methods. J Clin Endocrinol Metab 2006; 91: 3725–45.
16. LedinghamIMCA, WattI. Influence of sedation on mortality in critically ill multiple trauma patients. Lancet 1983; 1: 1270.
17. AbsalomA, PledgerD, KongA.Adrenocortical function in critically ill patients 24h after a single dose of etomidate. Anaesthesia 1999; 54: 861–7.
18. AnnaneD. Glucocorticoids in the treatment of severe sepsis and septic shock. Curr Opin Crit Care 2005; 11: 449–53.
19. LeferingR, NeugebauerEAM. Steroid controversy in sepsis and septic shock: a meta-analysis. Crit Care Med 1995; 23: 1294–303.
20. CroninL, CookDJ, CarletJ, et al. Corticosteroid treatment for sepsis: a critical appraisal and meta-analysis of the literature. Crit Care Med 1995; 23: 1430–9.
21. MinneciPC, DeansKJ, BanksSM, et al. Meta-analysis: The effect of steroids on survival and shock during sepsis depends on the dose. Ann Intern Med 2004; 141: 47–56.
22. BollaertPE, CharpentierC, LevyB, et al. Reversal of late septic shock with supraphysiological doses of hydrocortisone. Crit Care Med 1998; 26: 645–50.
23. BriegelJ, ForstH, HallerM, et al. Stress doses of hydrocortisone reverse hyperdynamic septic shock: A prospective, randomised, double-blind, single center study. Crit Care Med 1999; 27: 723–32.
24. AnnaneD, SebilleV, BollaertPE, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288: 862–71.
25. SprungCL, AnnaneD, KehD, et al. Hydrocortisone therapy for patients with septic shock. N Engl J Med 2008; 358: 111–24.
26. DellingerRP, LevyMM, CarletJ, et al. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med 2008; 34: 17–60.
27. JantzMA, SahnSA. Corticosteroids in acute respiratory failure. Am J Respir Crit Care Med 1999; 160: 1079–100.
28. BernardGR, ArtigasA, BrighamKL, et al. The American-European Consensus Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994; 149: 818–24.
29. RubenfeldGD, CaldwellE, PeabodyE, et al. Incidence and outcomes of acute lung injury. N Engl J Med 2005; 353:1685–93.
30. ARDSnet. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000; 342: 1301–8.
31. WareLB, MatthayMA. The acute respiratory distress syndrome. N Engl J Med 2000; 342: 1334–49.
32. MeduriGU, TolleyEA, ChrousosGP, StentzF. Prolonged methylprednisolone treatment suppresses systemic inflammation in patients with unresolving acute respiratory distress syndrome. Am J Respir Crit Care Med 2002; 165: 983–91.
33. MeduriGU, TolleyEA, ChinnA, StentzF, PostlethwaiteA. Procollagen types I and III aminoterminal propeptide levels during acute respiratory distress syndrome and in response to methylprednisolone treatment. Am J Respir Crit Care Med 1998; 158: 1432–41.
34. BoneRC, FisherCJ, ClemmerTP, SlotmanGJ, MetzCA. Early methylprednisolone treatment for septic syndrome and the adult respiratory distress syndrome. Chest 1987; 92: 1032–6.
35. BernardGR, LuceJM, SprungCL, et al. High dose corticosteroids in patients with the adult respiratory distress syndrome. N Engl J Med 1987; 317: 1565–70.
36. LuceJM, MontgomeryAB, MarksJD, TurnerJ, MetzCA, MurrayJF. Ineffectiveness of high-dose methylprednisolone in preventing parenchymal lung injury and improving mortality in patients with septic shock. Am Rev Respir Dis 1988; 138: 62–8.
37. MeduriGU, HeadleyAS, GoldenE, et al. Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome. N Engl J Med 1998; 280: 159–65.
38. SteinbergKP, HudsonLD, GoodmanRB, et al. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med 2006; 354: 1671–84.
39. MeduriGU, GoldenE, FreireAX, et al. Methylprednisolone infusion in early severe Acute Respiratory Distress Syndrome: Results of a randomised controlled trial. Chest 2007; 131: 954–63.
40. PeterJV, JohnP, GrahamPL, et al. Corticosteroids in the prevention and treatment of acute respiratory distress syndrome (ARDS) in adults: Meta-analysis. BMJ 2008; 336: 1006–9.
41. BrielM, BucherHC, BoscacciR, et al. Adjunctive corticosteroids for pneumocystis jiroveci pneumonia in patients with HIV infection. Cochrane Database Syst Rev 2006; 3: CD 006150.
42. ConfalonieriM, UrbinoR, PotenaA, et al. Hydrocortisone infusion for severe community-acquired pneumonia. Am J Respir Crit Care Med 2005; 171: 242–8.
43. ChengKC, HouCC, HuangHC, et al. Intravenous injection of methylprednisolone reduces the incidence of post-extubation stridor in intensive care unit patients. Crit Care Med 2006; 34: 1345–50.
44. FrancoisB, BellisantE, GissotV, et al. 12-h treatment with methylprednisolone versus placebo for prevention of post-extubation laryngeal oedema: a randomised double-blind trial. Lancet 2007; 369: 1083–9.
45. RabinsteinAA. Treatment of cerebral edema. Neurologist 2006; 12: 59–73.
46. CRASH trial collaborators. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury – outcomes at 6 months. Lancet 2005; 365: 1957–9.
47. De GansJ, Van de BeekD.Dexamethasone in adults with bacterial meningitis. N Engl J Med 2002; 347: 1549–56.
48. HurlbertRJ. Strategies of medical intervention in the management of acute spinal cord injury. Spine 2006; 11: S16–21.
49. BrackenMB. Pharmacological interventions for acute spinal cord injury (Cochrane Review). The Cochrane Library, Issue 2, 2002.
50.Trauma.org. Steroids in spinal cord injury, 2005. http://www.trauma.org/index.php/main/article/394, accessed 5 February, 2008.