ISSN 1662-4009 (online)

ey0015.8-10 | Important for Clinical Practice | ESPEYB15

8.10 Guidelines for the Diagnosis and Management of Critical Illness-Related Corticosteroid Insufficiency (CIRCI) in Critically Ill Patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017

D Annane , SM Pastores , B Rochwerg , W Arlt , RA Balk , A Beishuizen , J Briegel , J Carcillo , M Christ-Crain , MS Cooper , PE Marik , G Umberto Meduri , KM Olsen , SC Rodgers , JA Russell , G Van den Berghe

To read the full abstract: Crit Care Med. 2017; 45(12): 2078-2088This guideline replaces/updates the 2008 recommendations regarding the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. In CIRCI, inadequate glucocorticoid-mediated anti-inflammatory activity is observed in relation to the severity of the critical illne...

ey0021.8-5 | Important for Clinical Practice | ESPEYB21

8.5. High-resolution daily profiles of tissue adrenal steroids by portable automated collection

TJ Upton , E Zavala , P Methlie , O Kampe , S Tsagarakis , M Oksnes , S Bensing , DA Vassiliadi , MA Grytaas , IR Botusan , G Ueland , K Berinder , K Simunkova , M Balomenaki , D Margaritopoulos , N Henne , R Crossley , G Russell , ES Husebye , SL Lightman

Brief Summary: This paper describes a novel ambulatory fraction collector that can be used with microdialysis to obtain high resolution steroid profiles over a 24-hour period.Comment: The natural circadian and ultradian secretion of adrenal hormones makes single timepoint measurements of these hormones uninformative for clinical decision making (1-3). Repeated sampling during the day requires admission into an atypical, and often disruptive, clinical set...

ey0021.8-12 | Clinical Trials – New Treatments | ESPEYB21

8.12. Ultradian hydrocortisone replacement alters neuronal processing, emotional ambiguity, affect and fatigue in adrenal insufficiency: the PULSES trial

G Russell , K Kalafatakis , C Durant , N Marchant , J Thakrar , R Thirard , J King , J Bowles , T Upton , NJ Thai , JCW Brooks , A Wilson , K Phillips , S Ferguson , M Grabski , CA Rogers , T Lampros , S Wilson , C Harmer , M Munafo , SL Lightman

Brief Summary: This 6-week randomized, crossover, double blind, placebo-controlled feasibility trial assessed the effect of subcutaneous pump hydrocortisone on the quality of life, mood, functional neuroimaging, behavioral/cognitive responses, sleep and metabolism in adults with primary adrenal insufficiency (PAI) compared to standard therapy.Comment: Adrenal glucocorticoid secretion is characterized by a complex diurnal variation, formed by changes in p...