Can 1 microg of cosyntropin be used to evaluate adrenal insufficiency in critically ill patients?
Author(s): Kozyra EF, Wax RS, Burry LD Affiliation(s): Medical-Surgical ICU, Mount Sinai Hospital, Toronto, Ontario, Canada. Publication date & source: 2005-04, Ann Pharmacother., 39(4):691-8. Epub 2005 Mar 1. Publication type: Review OBJECTIVE: To evaluate the utility of cosyntropin 1 microg in assessing adrenal function in critically ill patients. DATA SOURCES: A computerized literature search using MEDLINE, EMBASE, International Pharmaceutical Abstracts, and the Cochrane Database (1966-August 2004) was undertaken for trials evaluating cosyntropin 1 mug using the following search terms: adrenocorticotropin-releasing hormone (ACTH), cosyntropin, adrenal insufficiency, cortisol, corticosteroids, glucocorticoids, sepsis, septic shock, diagnosis, critically ill, intensive care, and critical care. STUDY SELECTION AND DATA SYNTHESIS: Identifying patients with sepsis with relative adrenal insufficiency (AI) using cosyntropin testing may identify those likely to benefit from corticosteroids.
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