Hormonal therapies in septic shock

Kathryn Felmet, Karen Choong, Niranjan Kissoon

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Endocrine dysfunction is common in severe sepsis and is associated with increased morbidity and mortality risk. Clinical detection of this heterogenous disorder is limited, and the accuracy of laboratory diagnosis is complicated by the limitations in hormonal assays and the variable definitions used in its diagnosis. This article reviews the common hormone therapies that have been evaluated in the critically ill patient with sepsis, namely corticosteroids, vasopressin and insulin. There are numerous adult clinical trials in this area, some of which have revealed conflicting results. Pediatric data is much more limited. We present current recommendations for hormone therapy in adults and children, but caution that further study is needed to better understand the dynamic and complex endocrine responses during septic shock, and to develop improved methods for diagnosis and monitoring of patient response, so that we can determine not only which therapies to use, but how, in what combinations, and in which patients.

Original languageEnglish (US)
Pages (from-to)119-126
Number of pages8
JournalJournal of Pediatric Infectious Diseases
Volume4
Issue number2
DOIs
StatePublished - 2009
Externally publishedYes

Fingerprint

Septic Shock
Sepsis
Hormones
Clinical Laboratory Techniques
Physiologic Monitoring
Vasopressins
Critical Illness
Adrenal Cortex Hormones
Therapeutics
Clinical Trials
Insulin
Pediatrics
Morbidity
Mortality

Keywords

  • Corticosteroids
  • Hormone
  • Insulin
  • Sepsis
  • Vasopressin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases

Cite this

Hormonal therapies in septic shock. / Felmet, Kathryn; Choong, Karen; Kissoon, Niranjan.

In: Journal of Pediatric Infectious Diseases, Vol. 4, No. 2, 2009, p. 119-126.

Research output: Contribution to journalArticle

Felmet, Kathryn ; Choong, Karen ; Kissoon, Niranjan. / Hormonal therapies in septic shock. In: Journal of Pediatric Infectious Diseases. 2009 ; Vol. 4, No. 2. pp. 119-126.
@article{d9a397e0af0d4c1aa98398971c7119bb,
title = "Hormonal therapies in septic shock",
abstract = "Endocrine dysfunction is common in severe sepsis and is associated with increased morbidity and mortality risk. Clinical detection of this heterogenous disorder is limited, and the accuracy of laboratory diagnosis is complicated by the limitations in hormonal assays and the variable definitions used in its diagnosis. This article reviews the common hormone therapies that have been evaluated in the critically ill patient with sepsis, namely corticosteroids, vasopressin and insulin. There are numerous adult clinical trials in this area, some of which have revealed conflicting results. Pediatric data is much more limited. We present current recommendations for hormone therapy in adults and children, but caution that further study is needed to better understand the dynamic and complex endocrine responses during septic shock, and to develop improved methods for diagnosis and monitoring of patient response, so that we can determine not only which therapies to use, but how, in what combinations, and in which patients.",
keywords = "Corticosteroids, Hormone, Insulin, Sepsis, Vasopressin",
author = "Kathryn Felmet and Karen Choong and Niranjan Kissoon",
year = "2009",
doi = "10.3233/JPI-2009-0153",
language = "English (US)",
volume = "4",
pages = "119--126",
journal = "Journal of Pediatric Infectious Diseases",
issn = "1871-0336",
publisher = "IOS Press",
number = "2",

}

TY - JOUR

T1 - Hormonal therapies in septic shock

AU - Felmet, Kathryn

AU - Choong, Karen

AU - Kissoon, Niranjan

PY - 2009

Y1 - 2009

N2 - Endocrine dysfunction is common in severe sepsis and is associated with increased morbidity and mortality risk. Clinical detection of this heterogenous disorder is limited, and the accuracy of laboratory diagnosis is complicated by the limitations in hormonal assays and the variable definitions used in its diagnosis. This article reviews the common hormone therapies that have been evaluated in the critically ill patient with sepsis, namely corticosteroids, vasopressin and insulin. There are numerous adult clinical trials in this area, some of which have revealed conflicting results. Pediatric data is much more limited. We present current recommendations for hormone therapy in adults and children, but caution that further study is needed to better understand the dynamic and complex endocrine responses during septic shock, and to develop improved methods for diagnosis and monitoring of patient response, so that we can determine not only which therapies to use, but how, in what combinations, and in which patients.

AB - Endocrine dysfunction is common in severe sepsis and is associated with increased morbidity and mortality risk. Clinical detection of this heterogenous disorder is limited, and the accuracy of laboratory diagnosis is complicated by the limitations in hormonal assays and the variable definitions used in its diagnosis. This article reviews the common hormone therapies that have been evaluated in the critically ill patient with sepsis, namely corticosteroids, vasopressin and insulin. There are numerous adult clinical trials in this area, some of which have revealed conflicting results. Pediatric data is much more limited. We present current recommendations for hormone therapy in adults and children, but caution that further study is needed to better understand the dynamic and complex endocrine responses during septic shock, and to develop improved methods for diagnosis and monitoring of patient response, so that we can determine not only which therapies to use, but how, in what combinations, and in which patients.

KW - Corticosteroids

KW - Hormone

KW - Insulin

KW - Sepsis

KW - Vasopressin

UR - http://www.scopus.com/inward/record.url?scp=63049099307&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=63049099307&partnerID=8YFLogxK

U2 - 10.3233/JPI-2009-0153

DO - 10.3233/JPI-2009-0153

M3 - Article

VL - 4

SP - 119

EP - 126

JO - Journal of Pediatric Infectious Diseases

JF - Journal of Pediatric Infectious Diseases

SN - 1871-0336

IS - 2

ER -