Metabolic and Endocrine Challenges

Gennaro Martucci, Eleonora Bonicolini, Dhruv Parekh, Onn Shaun Thein, Mario Scherkl, Karin Amrein

Research output: Contribution to journalArticlepeer-review


This review aims to provide an overview of metabolic and endocrine challenges in the setting of intensive care medicine. These are a group of heterogeneous clinical conditions with a high degree of overlap, as well as nonspecific signs and symptoms. Several diseases involve multiple organ systems, potentially causing catastrophic dysfunction and death. In the majority of cases, endocrine challenges accompany other organ failures or manifest as a complication of prolonged intensive care unit stay and malnutrition. However, when endocrine disorders present as an isolated syndrome, they are a rare and extreme manifestation. As they are uncommon, these can typically challenge both with diagnosis and management. Acute exacerbations may be elicited by triggers such as infections, trauma, surgery, and hemorrhage. In this complex scenario, early diagnosis and prompt treatment require knowledge of the specific endocrine syndrome. Here, we review diabetic coma, hyponatremia, hypercalcemia, thyroid emergencies, pituitary insufficiency, adrenal crisis, and vitamin D deficiency, highlighting diagnostic tools and tricks, and management pathways through defining common clinical presentations.

Original languageEnglish
Pages (from-to)78-97
Number of pages20
JournalSeminars in Respiratory and Critical Care Medicine
Issue number1
Publication statusE-pub ahead of print - Sep 3 2020


  • adrenal crisis
  • coma
  • critically ill patients
  • diabetes
  • pituitary insufficiency
  • thyroid emergencies

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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