<![CDATA[Stress from many sources, including pain, fever, and hypotension, activates the hypothalamic-pituitary-adrenal (HPA)axis with the sustained secretion of corticotropin and cortisol. Increased glucocorticoid action is an essential component of thestress response, and even minor degrees of adrenal insufficiency can be fatal in the stressed host. HPA dysfunction is a commonand underdiagnosed disorder in the critically ill. We review the risk factors, pathophysiology, diagnostic approach, and managementof HPA dysfunction in the critically ill]]>
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