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Updated: Aug 13, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Relative adrenal failure in the ICU: an identifiable problem requiring treatment
Hélène Gonzalez1, Olivier Nardi, Djillali Annane
1Service de Réanimation Médicale, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, 92380 Garches, France.
Abstract:
Critically ill patients at some stage may develop adrenal insufficiency (AI). This article reviews the mechanisms, diagnosis criteria, consequences, and treatment of AI in various ICU conditions. Glucocorticoid insufficiency may be related to a decrease in glucocorticoid synthesis (ie, adrenal insufficiency) or to a reduced delivery of glucocorticoid to target tissues and cells. Diagnosis relies on clinical suspicion and ACTH test results. The length of cortisol replacement therapy should be at least 7 days and the adjunction of fludrocortisone is recommended.
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