Hemodynamic instability secondary to adrenal insufficiency in a major burn patient

A 39-year-old man presented with 80% body surface area burned following a thermal accident. The patient showed hemodynamic instability and low response to intravenous fluids or vasopressors for 20 days in the intensive care unit (ICU). The adrenocorticotropic hormone (ACTH) test was consistent with adrenal insufficiency. After a 3-day steroid treatment, the patient's blood pressure was normal without the administration of any vasopressor.