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2.Corticosteroid Replacement in Critically Ill Patients

2.Corticosteroid Replacement in Critically Ill Patients

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Published by Dr.G.Bhanu Prakash
www.gims-org.com
www.gims-org.com

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Published by: Dr.G.Bhanu Prakash on Aug 30, 2010
Copyright:Attribution Non-commercial

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06/16/2012

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Corticosteroid Replacementin Critically Ill Patients
www.gims-org.com
 
Steroid Physiology
 
Basal Cortisol Production = 8-25 mg in 24hrs
Production can be increased 6-fold in stress
Diurnal pattern of cortisol production lost in stresssituations
Cortisol T
1/2
= 70-120 minutes
Bound to circulating CBG, albumin,
1-acidglycoprotein
10% free = biologically active
CBG decreases rapidly in critically ill pts
increasedfree cortisol

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