Ask AI

Library

Updates

Loading...

Table of contents

Critical illness-related corticosteroid insufficiency

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of critical illness-related corticosteroid insufficiency are prepared by our editorial team based on guidelines from the Surviving Sepsis Campaign (SSC 2021), the Infectious Diseases Society of America (IDSA/ATS 2019), the British Medical Journal (BMJ 2018), the European Association for the Study of the Liver (EASL 2018), and the European Society of ...
Show more

Diagnostic investigations

Adrenal function testing: as per ESICM/SCCM 2017 guidelines, insufficient evidence to recommend whether to use delta cortisol (change in baseline cortisol at 60 mins of < 9 mcg/dL) after cosyntropin (250 mcg) administration or random plasma cortisol of < 10 mcg/dL for the diagnosis of critical illness-related corticosteroid insufficiency.
Show 5 more
Create free account

Medical management

Corticosteroid administration, sepsis: as per SSC 2021 guidelines, consider administering IV corticosteroids in adult patients with septic shock and an ongoing requirement for vasopressor therapy.
E

More topics in this section

  • Corticosteroid administration (pneumonia)

  • Corticosteroid administration (ARDS)

  • Corticosteroid administration (meningitis)

  • Corticosteroid administration (major trauma)

  • Corticosteroid administration (cardiopulmonary bypass surgery)

  • Corticosteroid administration (cardiac arrest)

Specific circumstances

Patients with liver cirrhosis: as per EASL 2018 guidelines, diagnose relative adrenal insufficiency based on a delta serum total cortisol of < 248 nmol/L (9 mcg/dL) after 250 mcg corticotropin injection or a random total cortisol of < 276 nmol/L (< 10 mcg/dL).
B
Show 2 more