Acute adrenal insufficiency in the patient with burns

J. F. Murphy, G. F. Purdue, J. L. Hunt

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Acute adrenal insufficiency is an uncommon but devastating complication of severe burn injury. The diagnosis is rarely made antemortem. Acute, fatal, adrenal insufficiency developed in three patients among 807 critically ill patients with burns treated at this institution during the past 6 years. Thermal injuries elevate corticosteroid secretion for weeks after injury, severely stressing the adrenal glands. Overload of the hypothalamic-pituitary-adrenal axis is thought to make this system unusually vulnerable to acute infarction. Although the actual mechanism of adrenal hemorrhage is not clear, the combination of excessive adrenocorticotropic hormone stimulation and hemodynamic instability have been implicated in its evolution. Survival may be too short for characteristic Addisonian metabolic changes to develop. Acute adrenal insufficiency is a rare event that is historically associated with mcningococcemia, although any life-threatening illness may precipitate this catastrophe. Therefore, when a sudden deterioration in the patient with thermal injuries is encountered, adrenal insufficiency must be considered. Copyright.

Original languageEnglish (US)
Pages (from-to)155-157
Number of pages3
JournalJournal of Burn Care and Rehabilitation
Volume14
Issue number2
DOIs
StatePublished - 1993

ASJC Scopus subject areas

  • Surgery
  • Nursing(all)
  • Emergency Medicine
  • Rehabilitation
  • Health Professions(all)

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