Mateos Moreno Laura, Palacios García Nuria, Estrada García Francisco Javier
Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
Endocrinol Diabetes Nutr. 2017 Dec;64(10):557-563. doi: 10.1016/j.endinu.2017.09.004. Epub 2017 Nov 12.
Recently, there have been advances in understanding of the changes that occur in the hypothalamic-pituitary-adrenal axis during the different stages of critical disease. Such advances have led to a paradigm change, so that the aforementioned adaptations are no longer considered the result of adrenal axis activation, but a consequence of decreased cortisol metabolism illness. Knowledge of this new pathophysiological bases should lead to reconsider the diagnosis and treatment of adrenal insufficiency in critically ill patients, a condition poorly understood to date.
最近，在理解危重病不同阶段下丘脑-垂体-肾上腺轴所发生变化方面取得了进展。这些进展导致了一种范式转变，即上述适应性变化不再被认为是肾上腺轴激活的结果，而是皮质醇代谢疾病减少的后果。了解这一新的病理生理基础应促使重新考虑危重病患者肾上腺功能不全的诊断和治疗，而迄今为止这种情况仍了解甚少。
