Spijkstra J J, Thijs L G
Surgical Intensive Care and bMedical Intensive Care, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Curr Opin Anaesthesiol. 2000 Apr;13(2):99-103. doi: 10.1097/00001503-200004000-00003.
Corticosteroids are of key importance in controlling the immune system and in the maintenance of cardiovascular function. Thus, an adequate function of the adrenal cortex is essential for survival in critical illness. There is growing evidence that adrenocortical function can become impaired during critical illness, because of deleterious effects of cytokines, leading to a state of relative adrenal dysfunction. Under these circumstances, administration of corticosteroids is necessary for recovery of the patient. How such a state of adrenal dysfunction should be detected is still not clear, however, making it difficult to decide when to administer corticosteroids and to which patients.
皮质类固醇在控制免疫系统和维持心血管功能方面至关重要。因此，肾上腺皮质的充分功能对于危重病患者的生存至关重要。越来越多的证据表明，在危重病期间，由于细胞因子的有害作用，肾上腺皮质功能可能会受损，导致相对肾上腺功能不全的状态。在这种情况下，给予皮质类固醇对于患者的康复是必要的。然而，目前仍不清楚应如何检测这种肾上腺功能不全的状态，这使得难以决定何时以及对哪些患者给予皮质类固醇。
