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Review Article
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- Critical illness-related corticosteroid insufficiency: latest pathophysiology and management guidelines
- Fremita Chelsea Fredrick, Anish Kumar Reddy Meda, Bhupinder Singh, Rohit Jain
- Acute Crit Care. 2024;39(3):331-340. Published online August 30, 2024
- DOI: https://doi.org/10.4266/acc.2024.00647
- 51,591 View
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- 8 Web of Science
- 10 Crossref
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Abstract
PDF - Intensive care unit (ICU) admissions in the United States exceed 5.7 million annually, often leading to complications such as post-intensive care syndrome and high mortality rates. Among these challenges, critical illness-related corticosteroid insufficiency (CIRCI) requires emphasis due to its complex, multiple-cause pathophysiology and varied presentations. CIRCI, characterized by adrenal insufficiency during critical illness, presents in up to 30% of ICU patients and may manifest as an exaggerated inflammatory response. Factors such as dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, altered cortisol metabolism, tissue corticosteroid resistance, and drug-induced suppression contribute to CIRCI. Diagnosis is a complex process, relying on a comprehensive assessment including clinical presentation, laboratory findings, and dynamic stimulatory testing. Treatment involves intensive medical care and exacting glucocorticoid therapy. Recent guidelines advocate for individualized approaches tailored to patient presentation and etiology. Understanding the pathophysiology and treatment of CIRCI is vital for clinicians managing critically ill patients and striving to improve outcomes. This research paper aims to explore the latest developments in the pathophysiology and management of CIRCI.
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Citations
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Pharmacology & Therapeutics.2026; 278: 108971. CrossRef - Brain-Region-Mediated Neuroimmune Modulation in Sepsis: Research Advances and Therapeutic Prospects
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Journal of Inflammation Research.2026; Volume 19: 1. CrossRef - Higher Serum Cortisol is Associated with Delayed Shock Resolution in Septic Shock Patients
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Nature Medicine.2025; 31(12): 4119. CrossRef - Cortisol Testing in Septic Shock: An Evaluation of Diagnostic Performance and Predictors of Corticosteroid Use in a Middle Eastern Cohort
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