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Chapter: Clinical Cases in Anesthesia : Perioperative Corticosteroid Administration

How is adrenal reserve evaluated?

The most commonly performed outpatient test for adrenal reserve is a urinary free cortisol collection over 24 hours.

How is adrenal reserve evaluated?

 

The most commonly performed outpatient test for adrenal reserve is a urinary free cortisol collection over 24 hours. For hospitalized patients, the ACTH stimulation test is most commonly performed to determine the pres-ence of adequate adrenal function. This screening test entails the measurement of a baseline plasma cortisol, fol-lowed by a measurement at 30 and 60 minutes after the intravenous administration of 250 μg of cosyntropin, an ACTH analog. During periods of stress, the baseline plasma cortisol level should exceed 20 μg/dL and all patients should have a rise in their plasma cortisol level of at least 7 μg/dL above their baseline.

 

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Clinical Cases in Anesthesia : Perioperative Corticosteroid Administration : How is adrenal reserve evaluated? |


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