In this episode, Dr. Jonathan Charnin and Dr. Daniel Saddawi-Konefka join us to explore the evidence around perioperative stress dose steroids and adrenal insufficiency.

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Music by Stephen Campbell, MD.

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References

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Bromberg JS, Baliga P, Cofer JB, et al. Stress steroids are not required for patients receiving a renal allograft and undergoing operation. J Am Coll Surg 1995;180:532–536.

Christy NP. Corticosteroid withdrawal. In: Current Therapy in Endocrinology and Metabolism, 3rd Ed, Bardin CW (Ed), BC Decker, New York 1988. P.113.

Glowniak JV, Loriaux DL. A double-blind study of perioperative steroid requirements in secondary adrenal insufficiency. Surgery. 1997 Feb;121(2):123-9. doi: 10.1016/s0039-6060(97)90280-4. PMID: 9037222.

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LEWIS L, ROBINSON RF, YEE J, HACKER LA, EISEN G. Fatal adrenal cortical insufficiency precipitated by surgery during prolonged continuous cortisone treatment. Ann Intern Med. 1953 Jul;39(1):116-26. doi: 10.7326/0003-4819-39-1-116. PMID: 13065993.

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Prete A, Yan Q, Al-Tarrah K, Akturk HK, Prokop LJ, Alahdab F, Foster MA, Lord JM, Karavitaki N, Wass JA, Murad MH, Arlt W, Bancos I. The cortisol stress response induced by surgery: A systematic review and meta-analysis. Clin Endocrinol (Oxf). 2018 Nov;89(5):554-567. doi: 10.1111/cen.13820. Epub 2018 Aug 23. PMID: 30047158.

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