Related Experiment Video

Updated: Sep 18, 2025

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids
08:02

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids

Published on: April 25, 2016

9.8K

Adrenal Insufficiency After Glucocorticoid Use in the Pediatric Intensive Care Unit

Ashley N Radig1, Vanessa A Curtis1, Erik Westlund2

  • 1Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Journal of Intensive Care Medicine
|June 26, 2025
PubMed

Insights

Pediatric critical illness survivors receiving glucocorticoids have a 2.3% risk of developing adrenal insufficiency. Younger age, longer hospital stays, and higher glucocorticoid doses were associated with this condition, necessitating further research.

Area of Science:

  • Pediatric Critical Care Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Glucocorticoids are frequently administered to critically ill children.
  • Glucocorticoid use in pediatric intensive care units (PICU) may lead to subsequent adrenal insufficiency.
  • Adrenal insufficiency contributes to morbidity in survivors of pediatric critical illness.

Purpose of the Study:

  • To determine the prevalence of adrenal insufficiency in children exposed to glucocorticoids during PICU admission.
  • To identify risk factors associated with the development of adrenal insufficiency in this population.

Main Methods:

  • Retrospective cohort study involving a structured medical record review.
  • Inclusion of pediatric patients (0-18 years) admitted to an academic tertiary referral PICU over two years who received glucocorticoids.
  • Analysis of clinical characteristics and diagnosis of adrenal insufficiency.

Main Results:

  • Adrenal insufficiency was diagnosed in 2.3% of 530 patients who received glucocorticoids.
  • Patients with adrenal insufficiency were younger, had longer PICU and hospital stays, and a lower 1-year survival rate.
  • Higher glucocorticoid doses and use for hyperinflammation were associated with adrenal insufficiency, while steroid taper was more frequent.

Conclusions:

  • A notable percentage of pediatric patients receiving glucocorticoids in the PICU develop adrenal insufficiency.
  • Potential risk factors for post-glucocorticoid adrenal insufficiency were identified.
  • Further research is warranted to understand and mitigate the impact of adrenal insufficiency on critically ill children's outcomes.

Keywords:
adrenal insufficiencycortisolglucocorticoidspediatric intensive care unitspediatricssteroids

More Related Videos

A Novel Method: Super-selective Adrenal Venous Sampling06:08

A Novel Method: Super-selective Adrenal Venous Sampling

Published on: September 15, 2017

23.6K
Primary Culture of Rat Adrenocortical Cells and Assays of Steroidogenic Functions04:33

Primary Culture of Rat Adrenocortical Cells and Assays of Steroidogenic Functions

Published on: March 12, 2019

8.2K

Related Concept Videos

Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
1.9K
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
399
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
351
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
270
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
105
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
83