Critical Illness-Related Corticosteroid Insufficiency in the Intensive Care Patient

  • Noelle N. SaillantEmail author
  • Carrie Sims


Managing critical illness-related corticosteroid insufficiency (CIRCI) is a challenging endeavor for the surgical intensivist. The mechanisms underlying CIRCI remain incompletely characterized. Moreover, optimal methods of diagnosing and managing CIRCI remain to be determined. This chapter will summarize the salient features of CIRCI and review the best available guidelines for treating this complex disorder.


Critical illness-related corticosteroid insufficiency (CIRCI) Stress dose steroids Glucocorticoids Hypothalamic-pituitary (HPA) axis Adrenal insufficiency 


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Authors and Affiliations

  1. 1.Department of Surgery, Beth Israel Deaconess Medical CenterBostonUSA
  2. 2.Division of Trauma, Surgical Critical Care, and Emergency Surgery, Department of SurgeryUniversity of PennsylvaniaPhiladelphiaUSA

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