A burn patient in the intensive care unit (ICU) may develop adrenal insufficiency. Certain risk factors may help to identify a patient who should be screened.
Adrenal insufficiency may cause hypotension, hemodynamic instability or a poor response to pressors. It is associated with increased ventilation, length of stay and mortality.
Risk factors for adrenal insufficiency according to Reiff et al:
(1) older age (mean 50 years)
(2) greater TBSA (mean TBSA 46%)
Risk factors of Graves et al for critical illness-related corticosteroid insufficiency:
(1) inhalation injury
(2) greater Charlson comorbidity score
Risk factor of Mosier et al:
(1) etomidate therapy (transient)
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