Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients : Consensus statements from an international task force by the American College of Critical Care Medicine

*See also p. 1987. From the Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University, Philadelphia, PA (PEM); Critical Care Medicine Fellowship Program, Memorial SloanKettering Cancer Center, New York, NY (SMP); Critical Care Department, Universite de Versailes Saint-Quentin en Yvelines, Hospital Raymond Poincare, Garches, France (DA); Division of Pulmonary and Critical Care Medicine, University of Tennessee HSC, Memphis, TN (GUM); Department of Anesthesiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (CLS); Division of Medical Sciences, Institute of Biomedical Research, Endocrinology & Metabolism, The Medical School, University of Birmingham, Birmingham, UK (WA); Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Clinic, Humboldt University, Berlin, Germany (DK); Department of Anesthesiology, University of Munich, Klinikum Grosshadern, Munich, Germany (JB); Department of Intensive Care, VU University Medical Center, Amsterdam, Netherlands (AB); Department of Critical Care Medicine, Athens University, Medical School, Athens, Greece (ID); Department of Endocrinology, Athens’ Polyclinic, Athens, Greece (ST); Department of Medicine and Wolfson Institute of Biomedical Research, University College London, Jules Thorn Building, Middlesex Hospital, London, UK (MS); First Department of Pediatrics, Athens University Medical School, Athens, Greece (GPC); Baxter Healthcare, Clintec Nutrition, Deerfield, IL (GZ); Department of Trauma, Stronger Hospital of Cook County, Chicago, IL (FB); Hospital of the University of Munich, Institute of Clinical Chemistry, Munich, Germany (MV). The American College of Critical Care Medicine (ACCM), which honors individuals for their achievements and contributions to multidisciplinary critical care medicine, is the consultative body of the Society of Critical Care Medicine (SCCM) that possesses recognized expertise in the practice of critical care. The College has developed administrative guidelines and clinical practice parameters for the critical care practitioner. New guidelines and practice parameters are continually developed, and current ones are systematically reviewed and revised. Dr. Marik has received lecture fees from Eli Lilly and Merck. Dr. Keh has received grant support from the German Research Foundation and German Ministry of Education and Research (HYPRESS: Hydrocortisone for Prevention of Septic Shock). Dr. Sprung has been a member of a data monitoring and safety committee for Artisan Pharma, Novartis Corporation, and Hutchinson Technology Incorporated. He has served as a consultant for AstraZeneca, Eisai Corporation, Eli Lilly, and GlaxoSmithKline. He has received grant support from the European Commission, Takeda, and Eisai Corporation. He has received lecture fees from Eli Lilly. Drs. Sprung, Annane, Keh, Singer, and Briegel were investigators in the CORTICUS study, which was supported by the European Commission, the European Society of Intensive Care Medicine, the European Critical Care Research Network, the International Sepsis Forum, and the Gorham Foundation. Dr. Annane has received grant support from the French Ministry of Health for the prognostic value of a adrenocorticotrophic hormone test in septic shock; the French multicenter, randomized, controlled trial on hydrocortisone plus fludrocortisone in septic shock; the ongoing French multicenter 2 2 factorial study that compares strict glucose control vs. conventional treatment for steroid-treated septic shock and hydrocortisone alone vs. hydrocortisone and fludrocortisone; and a French multicenter 2 2 factorial trial that compares hydrocortisone plus fludrocortisone, activated protein C, the combination of the two drugs, and placebos for the treatment of septic shock. Dr. Pastores has received grant support form Eisai Medical Research (phase 3 trial of E5564 in severe sepsis), and Artisan Pharma (phase 2 sepsis with disseminated intravascular coagulation trial). The remaining authors have not disclosed any conflicts of interest with respect to this article. For information regarding this article, E-mail: paul.marik@jefferson.edu Copyright © 2008 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins