ICU SAQs · Physiology / endocrine
The hypothalamic-pituitary-adrenal axis and the stress response
A CICM First Part SAQ — the HPA axis (CRH/ACTH/cortisol), the negative feedback, the cortisol effects, and the critical-illness-related corticosteroid insufficiency (CIRCI).
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CICMFFICMEDIC
Prompt
Outline the HPA axis and explain how the cortisol changes in the critical illness.
Question
Outline the hypothalamic-pituitary-adrenal (HPA) axis and explain how cortisol physiology changes in critical illness.[1]
References3ShowHide
- [1]Dutt M, Wehrle CJ, Jialal I Physiology, Adrenal Gland. 2023.PMID 30725945
- [2]Marik PE, Pastores SM, Annane D, et al. Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients: consensus statements from an international task force by the American College of Critical Care Medicine. Critical care medicine, 2008.PMID 18496365
- [3]Annane D, Pastores SM, Rochwerg B, et al. Guidelines for the Diagnosis and Management of Critical Illness-Related Corticosteroid Insufficiency (CIRCI) in Critically Ill Patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017. Critical care medicine, 2017.PMID 28938253