Endocrine Abstracts

The severely ill are a very heterogeneous group of patients but approximately half of all General Critical Care admissions suffer from severe sepsis. The presentation will therefore focus on the physiological and metabolic changes in this common critical care syndrome. Sepsis is initiated by microbiological invasion of host tissues and all severe cases are characterised by the rapid development of multiple organ failure. Outcome remains poor with in-hospital mortality in exces...

Critical illness is associated with dramatic changes in the glucocorticoid axis. These changes occur at all levels of the axis, are most obvious in the increased serum levels of glucocorticoid but also occur within the tissue. Frank impairment of these responses (e.g. in Addison’s disease or with drugs that block adrenal hormone secretion) is associated with an adverse outcome but it has recently been suggested that many critically ill patients develop subtle abnormalitie...

Alterations in thyroid function tests are common in non-thyroidal illness. There remains a significant debate as to whether these alterations contribute to morbidity and mortality. Recent data have highlighted the heterogeneity and natural history of altered thyroid function in non-thyroidal illness; particularly in relation to critical illness. Moreover, the biological mediators of these changes are becoming clearer. This presentation will review the physiology and pathophysi...

Recently, the concept that stress hyperglycemia in critically ill patients is an adaptive, beneficial response has been challenged. Two large randomized studies demonstrated that maintenance of normoglycemia with intensive insulin therapy substantially prevents morbidity and reduces mortality in these patients. Since then, questions have been raised about the efficacy in general and in specific subgroups, and about the safety of this therapy with regard to potential harm of br...