Home

Search

Pathway AI

Account ⋅ Sign Out

Table of contents

Critical illness-related corticosteroid insufficiency

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 Society of Intensive Care Medicine (ESICM/SCCM 2018; 2017), and the European Association for the Study of the Liver (EASL 2018).
1
2
3
4
5
6

Guidelines

1.Diagnostic investigations

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

2.Medical management

Corticosteroid administration, sepsis, SSC: 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)

3.Specific circumstances

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