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Interpreting Hormones in Critically Ill Patients

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Dr KVS Hari Kumar, Chandigarh    21 November 2018

  1. Endocrine axes undergo complex changes in critically ill patients. The hormonal alterations differ in acute and chronic phases of illness.
  2. Few hormone tests are influenced by the alteration in the binding proteins.
  3. Judicious checking is advised for de novo hormonal dysfunction in ICU.
  4. Interpret the results by keeping the background condition in view. The test results are also affected by many drugs that are used in the ICU.
  5. Repeat the tests whenever in doubt or mismatch with clinical setting.
  6. Monitor the adrenal and thyroid axes closely in the critically ill. Adrenal insufficiency and Sick euthyroid syndrome deserve special attention. Hydrocortisone is indicated in hypotension unresponsive to fluids and pressors.

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