Jacobi Judith
1 Pharmacy Department, Indiana University Health Methodist Hospital, Indianapolis, IN, USA.
J Pharm Pract. 2019 Jun;32(3):314-326. doi: 10.1177/0897190019834771. Epub 2019 Mar 10.
Endocrine emergencies are frequent in critically ill patients and may be the cause of admission or can be secondary to other critical illness. The ability to anticipate endocrine abnormalities such as adrenal excess or , hypothyroidism, can mitigate their duration and severity. Hyperglycemic crisis may trigger hospital and intensive care unit (ICU) admission and may be life threatening. Recognition and safe treatment of severe conditions such as acute adrenal insufficiency, thyroid crisis, and hypoglycemia and hyperglycemic crisis may be lifesaving. Electrolyte abnormalities such as hypercalcemia and hypocalcemia may have underlying endocrine causes, and may be treated differently with recognition of those disorders- electrolyte replacement alone may not be adequate for efficient resolution. Sodium disorders are common in the ICU and are generally related to altered water balance however may be related to pituitary abnormalities in selected patients, and recognition may improve treatment effectiveness and safety.
内分泌急症在危重症患者中很常见,可能是入院原因,也可能继发于其他危重病。能够预见到诸如肾上腺功能亢进或甲状腺功能减退等内分泌异常情况,可减轻其持续时间和严重程度。高血糖危象可能促使患者入住医院和重症监护病房(ICU),且可能危及生命。识别并安全治疗诸如急性肾上腺功能不全、甲状腺危象、低血糖和高血糖危象等严重病症可能挽救生命。高钙血症和低钙血症等电解质异常情况可能有潜在的内分泌病因,认识到这些病症后治疗方式可能有所不同——仅靠补充电解质可能不足以有效解决问题。钠紊乱在ICU很常见,通常与水平衡改变有关,但在特定患者中可能与垂体异常有关,识别这些情况可能提高治疗效果和安全性。