This review will provide an updated overview of the neuroendocrine response to critical illness. Specifically, the current evidence for "stress steroid" administration will be examined, as well as interventional glucose control during critical illness. The emergency physician will also find relevance in the alterations of thyroid hormones that occur in the face of severe illness or trauma.
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http://dx.doi.org/10.1016/j.emc.2005.03.015 | DOI Listing |
Anesth Analg
January 2025
School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.
Background: Some studies suggest that balanced solutions may improve outcomes in critical care patients. However, in patients with traumatic brain injury (TBI) existing data indicate that normal saline may be preferred. We hypothesized that mortality in critically ill patients with and without TBI would differ with the use of balanced salt solutions versus normal saline.
View Article and Find Full Text PDFJ Vet Emerg Crit Care (San Antonio)
January 2025
Critical Care, Blue Pearl, Tampa, Florida, USA.
Objective: To retrospectively compare and report vasopressor duration and mortality of septic dogs with hypotension refractory to vasopressor administration (presumed critical illness-related corticosteroid insufficiency [CIRCI]) treated with or without dexamethasone sodium phosphate (DxSP).
Design: Retrospective study (2017-2022).
Setting: Tertiary referral and teaching hospitals.
World J Psychiatry
January 2025
Digestive Physiology and Gastrointestinal Motility Lab, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz 91700, Mexico.
This article examines the complex relationship between disease perception, negative emotions, and their impact on postoperative recovery in patients with perianal diseases. These conditions not only cause physical discomfort, but also carry a significant emotional burden, often exacerbated by social stigma. Psychological factors, including stress, anxiety, and depression, activate neuroendocrine pathways, such as the hypothalamic-pituitary-adrenal axis, disrupting the gut microbiota and leading to dysbiosis.
View Article and Find Full Text PDFCrit Care Explor
January 2025
Division of Cardiovascular Critical Care Medicine, Department of Cardiology, Boston Children's Hospital, Boston, MA.
Background: Accurate assessment of oxygen delivery relative to oxygen demand is crucial in the care of a critically ill patient. The central venous oxygen saturation (Svo) enables an estimate of cardiac output yet obtaining these clinical data requires invasive procedures and repeated blood sampling. Interpretation remains subjective and vulnerable to error.
View Article and Find Full Text PDFBackground: Aneurysmal subarachnoid hemorrhage (aSAH) causes systemic changes that contribute to delayed cerebral ischemia (DCI) and morbidity. Circulating metabolites reflecting underlying pathophysiological mechanisms warrant investigation as biomarker candidates.
Methods: Blood samples, prospectively collected within 24 hours (T1) of admission and 7-days (T2) post ictus, from patients with acute aSAH from two tertiary care centers were retrospectively analyzed.
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