Endocrine And Metabolic Critical Care

Several hormones in the body regulate metabolic processes. Alterations in the level of these hormones are generally managed through appropriate treatment and do not pose any emergencies. However, in some cases, significant alterations in hormonal levels require immediate medical interventions to prevent serious and life-threatening complications.

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Disease treated

  • Diabetic Ketoacidosis (DKA): DKA is a life-threatening condition that occurs in people with diabetes. It is characterized by an excessive synthesis of ketones by the body. If not treated, there is an accumulation of ketones. The symptoms include frequent urination, stomach pain, shortness of breath, and tiredness.
  • Severe Hypo & Hyper Glycemia: Severe hypoglycemia is a condition in which the blood sugar level of a person is at a significantly low level, which seriously affects physical and mental functions. Such patients require help from other people. Severe hyperglycemia is characterized by extremely elevated levels of blood sugar.
  • Thyroid Emergencies: Myxedema coma is a thyroid emergency, indicating extremely reduced levels of circulating thyroid hormones. In contrast, a thyroid storm is another thyroid emergency characterized by extremely high levels of circulating thyroid hormones. It is essential to recognize and treat these emergencies promptly.
  • Severe Electrolyte Imbalance: Electrolytes are essential for several vital functions. Severe electrolyte imbalance occurs when the levels of electrolytes in the blood are extremely low or high.
  • Diabetes Insipidus: It is a condition in which the patient cannot retain enough water in the body. If left untreated, it may cause severe dehydration and a significant loss of electrolytes.
  • Adrenal Disorders: Adrenal insufficiency, if not treated, may result in severe complications, such as kidney failure, extreme weakness, shock, low blood pressure, and severe abdominal pain.

Procedures and treatment

  • DKA Management: The treatment options for diabetic ketoacidosis are insulin therapy, fluid replacement, and administration of the electrolytes.
  • Insulin and Glucose Therapy: Evidence suggests that intensive insulin therapy to maintain glucose levels between 80–110 mg/dl reduces morbidity and mortality by preventing acute renal failure and the need for prolonged mechanical ventilation. Glucose therapy may be used for the management of hypoglycemia.
  • Hormonal Management: Hormones play a major role in regulating several vital processes in the body. It is vital to maintain normal levels of certain hormones in emergency conditions.
  • Dyselectrolytemia Correction: Electrolytes, such as potassium, sodium, bicarbonate, and chloride, are essential for maintaining pH and osmolarity. The concentration of electrolytes alters in several disease states, which increases the risk of complications. Therefore, it is crucial to correct electrolyte imbalances in emergency settings.