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Requirement of Perioperative Stress Doses of Corticosteroids

Requirement of Perioperative Stress Doses of Corticosteroids REVIEW ARTICLE Requirement of Perioperative Stress Doses of Corticosteroids A Systematic Review of the Literature Paul E. Marik, MD; Joseph Varon, MD Objective: To determine the requirement for periopera- Data Synthesis: Nine studies met our inclusion crite- ria, including 2 RCTs and 7 cohort studies. These studies tive supplemental (stress) doses of corticosteroids in pa- enrolled a total of 315 patients who underwent 389 sur- tients receiving long-term corticosteroid therapy and un- gical procedures. In the 2 RCTs, there was no difference dergoing a surgical procedure. Corticosteroids are among in the hemodynamic profile between patients receiving the most commonly prescribed medications and will pre- stress doses of corticosteroids compared with patients re- dictably result in suppression of the hypothalamic- ceiving only their usual daily dose of corticosteroid. In the pituitary-adrenal axis with long-term use. Patients re- 5 cohort studies in which patients continued to receive ceiving therapeutic dosages of corticosteroids frequently their usual daily dose of corticosteroid without the addi- require surgery; these patients are almost universally tion of stress doses, no patient developed unexplained hy- treated with stress doses of corticosteroids during the peri- potension or adrenal crisis. One patient in each of the 2 operative period. cohort http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Requirement of Perioperative Stress Doses of Corticosteroids

JAMA Surgery , Volume 143 (12) – Dec 1, 2008

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Publisher
American Medical Association
Copyright
Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/archsurg.143.12.1222
pmid
19075176
Publisher site
See Article on Publisher Site

Abstract

REVIEW ARTICLE Requirement of Perioperative Stress Doses of Corticosteroids A Systematic Review of the Literature Paul E. Marik, MD; Joseph Varon, MD Objective: To determine the requirement for periopera- Data Synthesis: Nine studies met our inclusion crite- ria, including 2 RCTs and 7 cohort studies. These studies tive supplemental (stress) doses of corticosteroids in pa- enrolled a total of 315 patients who underwent 389 sur- tients receiving long-term corticosteroid therapy and un- gical procedures. In the 2 RCTs, there was no difference dergoing a surgical procedure. Corticosteroids are among in the hemodynamic profile between patients receiving the most commonly prescribed medications and will pre- stress doses of corticosteroids compared with patients re- dictably result in suppression of the hypothalamic- ceiving only their usual daily dose of corticosteroid. In the pituitary-adrenal axis with long-term use. Patients re- 5 cohort studies in which patients continued to receive ceiving therapeutic dosages of corticosteroids frequently their usual daily dose of corticosteroid without the addi- require surgery; these patients are almost universally tion of stress doses, no patient developed unexplained hy- treated with stress doses of corticosteroids during the peri- potension or adrenal crisis. One patient in each of the 2 operative period. cohort

Journal

JAMA SurgeryAmerican Medical Association

Published: Dec 1, 2008

References