Division of Pulmonology and Critical Care, Allegheny Health Network, Pittsburgh, Pennsylvania (Drs Nasrullah, Azharuddin, Young, and Dumont); and Department of Nursing, Allegheny Health Network, Pittsburgh, Pennsylvania (Ms Kejas).
Crit Care Nurs Q. 2022;45(3):266-284. doi: 10.1097/CNQ.0000000000000411.
Endocrine emergencies are underdiagnosed and often overlooked amid the management of severe multisystem pathologies in critically ill patients in the medical intensive care unit (ICU). In an appropriate clinical scenario, a low threshold of suspicion should be kept to investigate for various life-threatening, yet completely treatable, endocrinopathies. Prompt identification and treatment of endocrine emergencies such as diabetic ketoacidosis, myxedema coma, thyroid storm, and/or adrenal insufficiency leads to fewer complications, shorter ICU and hospital stay, and improved survival. This review article entails common endocrine emergencies encountered in the ICU and addresses their epidemiology, pathophysiology, clinical presentation and management.
内分泌急症在重症监护病房(ICU)中对严重多系统疾病进行管理时经常被漏诊和忽视。在适当的临床情况下,应保持较低的怀疑阈值,以调查各种危及生命但完全可治疗的内分泌疾病。及时识别和治疗内分泌急症,如糖尿病酮症酸中毒、黏液水肿性昏迷、甲状腺危象和/或肾上腺功能不全,可减少并发症、缩短 ICU 和住院时间并提高生存率。本文综述了 ICU 中常见的内分泌急症,讨论了它们的流行病学、病理生理学、临床表现和治疗方法。