[Corticosteroids in XXXX ].

@entity1 @entity326 @entity3124 @entity1887 @entity2339 @entity701 @entity551 @entity774
Adequate adrenocortical function is essential to survive @entity3124 . Most @entity3124 @entity1 display an elevated plasma @entity701 level, reflecting activation of the @entity774 , which is considered to be a homeostatic adaptation. In the setting of @entity3124 , the failure of an appropriate neuroendocrine response can lead to the picture of vasopressor-dependent refractory @entity551 . In randomised trials with @entity1 in @entity326 , a more rapid haemodynamic recovery was obtained with physiological doses of @entity701 than with placebo. The observed haemodynamic response following @entity701 administration supports the concept of relative @entity1887 . Causes of this relative @entity1887 are a dysfunction of the @entity2339 and/or @entity701 resistance. There is increasing evidence that @entity701 physiology and regulation are substantially altered in the course of @entity326 . Several controlled studies have shown that stress doses of @entity701 given in @entity1 with @entity326 reduce the time to shock reversal and decrease mortality. A multicenter large-scale trial (CORTICUS) is on the way investigating the benefit of stress doses of @entity701 on the mortality of @entity326 . In this review glucocorticoid physiology and regulation during @entity326 and the effects of hydrocortison administration in the course of @entity326 are being discussed.
