[CK] Stress-dose gluticocorticoid(steroid) [v ] read and sum! (50mcg IVP solucortef vs 125mg solumedrol=for steroid user>5mg pred.)
STRESS DOSE Solucortef 50mg q6hr ! or Solumedrol 60-125mg iv q6-8hr !(severe sepsis shock or known prednisone user !) https://www.uptodate.com/contents/glucocorticoid-therapy-in-septic-shock?topicRef=1613&source=see_link Summary ● Random <10 but don't rely on lab test. => just do it if it's indicated in critically ill patient.s ● "functional" adrenal insufficiency, "relative" adrenal insufficiency, "critical illness-related corticosteroid insufficiency (CIRCI)." =But a clear definition is lacking ● Less severe septic shock: restored by fluid and pressor = corticosteroid therapy does not appear to be beneficial. ● Severe septic shock: sBP <90 with adequate fluid + vasopressor (more than 1 hr, NE >0.5) .=> may need to add 2nd dose or... = reduces weaning pressor quicker. => start within 24hours for severe septic shock. ● ACTH stimulation testing is not clinically useful. Recommendat