Interní Med. 2014; 16(2): 80-82

Preparing a steroid-dependent patient for surgery

doc.MUDr.Zdeněk Fryšák, CSc., doc.MUDr.David Karásek, Ph.D., MUDr.Milan Halenka, Ph.D.
III. interní klinika &ndash, revmatologie, nefrologie, endokrinologie, LF a FN Olomouc

A surgical procedure imposes a substantial burden to which an otherwise healthy body responds primarily by increased secretion of

cortisol, a steroid hormone, particularly with a glucocorticoid, and a less mineralocorticoid effect. However, this is only a substantial part

of a very complex process. Adrenal insufficiency, whether primary or secondary (impaired hypothalamic-pituitary-adrenal axis function),

poses an immediate life-threatening risk for the patient. Consequently, the management is in the hands of the attending physician who

must aid the patient in creating the conditions to manage this crisis situation.

Keywords: glucocorticoids, cortisol, adrenocorticotropic hormone (ACTH), mineralocorticoids, aldosterone (ALDO), renin

Published: April 20, 2014  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Fryšák Z, Karásek D, Halenka M. Preparing a steroid-dependent patient for surgery. Interní Med. 2014;16(2):80-82.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Axelrod L. Perioperative management of patients treated with glucocorticoids. Endocrinol Metab Clin North Am 2003; 32: 367. Go to original source... Go to PubMed...
    2. Dahl R. Systemic side effects of inhaled corticosteroids in patients with asthma. Respir Med 2006; 100: 1307. Go to original source... Go to PubMed...
    3. Glowniak JV, Loriaux DL. A double-blind study of perioperative steroid requirements in secondary adrenal insufficiency. Surgery 1997; 121: 123. Go to original source... Go to PubMed...
    4. Hengge UR, Ruzicka T, Schwartz RA, Cork MJ. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol 2006; 54: 1. Go to original source... Go to PubMed...
    5. LaRochelle GE Jr, LaRochelle AG, Ratner RE, Borenstein DG. Recovery of the hypothalamic-pituitary-adrenal (HPA) axis in patients with rheumatic diseases receiving low-dose prednisone. Am J Med 1993; 95: 258. Go to original source... Go to PubMed...
    6. Marik PE, Varon J. Requirement of perioperative stress doses of corticosteroids: a systematic review of the literature. Arch Surg 2008; 143: 1222. Go to original source... Go to PubMed...
    7. Salem M, Tainsh RE Jr, Bromberg J, et al. Perioperative glucocorticoid coverage. A reassessment 42 years after emergence of a problem. Ann Surg 1994; 219: 416. Go to original source... Go to PubMed...
    8. Westerhof L, Van Ditmars MJ, Der Kinderen PJ, et al. Recovery of adrenocortical function during long-term treatment with corticosteroids. Br Med J 1972; 2: 195. Go to original source... Go to PubMed...
    9. Yong SL, Coulthard P, Wrzosek A. Supplemental perioperative steroids for surgical patients with adrenal insufficiency. Cochrane Database Syst Rev 2012; 12:CD005367. Go to original source... Go to PubMed...

    Return to the content


    Internal Medicine for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.