RT Book, Section
A1 Whinney, Christopher M.
A1 Sahai, Sunil K.
A2 Cohn, Steven L.
SR Print(0)
ID 1179531189
T1 Adrenal Disease (Including Pheochromocytoma)
T2 Decision Making in Perioperative Medicine: Clinical Pearls
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781260468106
LK accessmedicine.mhmedical.com/content.aspx?aid=1179531189
RD 2024/04/23
AB Adrenal  function  is  critical  to  stability  in  the  surgical  milieu  in  order  to  maintain  hemodynamic  stability  and  end  organ  perfusion.1,2  The  stress  of  surgery,  trauma,  and  critical  illness,  and  the  vasodilation  associated  with  anesthesia,  in  conjunction  with  blood  loss  and  fluid  shifts,  can  lead  to  hypotension  and  shock  in  the  setting  of  inadequate  adrenal  reserves.  There  are  two  distinct  populations  of  relevance  in  this  regard:  patients  with  established  and  confirmed  primary  or  secondary  adrenal  insufficiency  (from  cortisol  or  ACTH  deficiency,  respectively),  and  patients  with  suspected  tertiary  adrenal  insufficiency  related  to  use  of  exogenous  glucocorticoid  therapy  that  suppresses  the  hypothalamic-pituitary-adrenal  (HPA)  axis  and  ACTH  release  from  the  hypothalamus.