{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T02:23:10Z","timestamp":1767666190741,"version":"3.37.3"},"reference-count":180,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Respir Crit Care Med"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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.<\/jats:p>","DOI":"10.1055\/s-0040-1713084","type":"journal-article","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T23:01:14Z","timestamp":1599174074000},"page":"078-097","source":"Crossref","is-referenced-by-count":4,"title":["Metabolic and Endocrine Challenges"],"prefix":"10.1055","volume":"42","author":[{"given":"Gennaro","family":"Martucci","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Bonicolini","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhruv","family":"Parekh","sequence":"additional","affiliation":[{"name":"Critical Care, Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onn Shaun","family":"Thein","sequence":"additional","affiliation":[{"name":"Critical Care, Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Scherkl","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0915-085X","authenticated-orcid":false,"given":"Karin","family":"Amrein","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,9,3]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1097\/MAJ.0b013e3181e5945b","article-title":"A dyshomeostasis of electrolytes and trace elements in acute stressor states: impact on the heart","volume":"340","author":"A D Whitted","year":"2010","journal-title":"Am J Med Sci"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1016\/j.chest.2015.12.001","article-title":"Ionized calcium in the ICU: Should it be measured and corrected?","volume":"149","author":"S K Aberegg","year":"2016","journal-title":"Chest"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/CCM.0b013e3181ffe23e","article-title":"Ionized calcium concentration and outcome in critical illness","volume":"39","author":"M Egi","year":"2011","journal-title":"Crit Care Med"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1097\/00000658-198510000-00011","article-title":"Hypercalcemia in critically ill surgical patients","volume":"202","author":"J Forster","year":"1985","journal-title":"Ann Surg"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s13613-019-0606-8","article-title":"Epidemiology, clinical features, and management of severe hypercalcemia in critically ill patients","volume":"9","author":"C Mousseaux","year":"2019","journal-title":"Ann Intensive Care"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1177\/0885066617706650","article-title":"Electrolyte disturbances in critically ill cancer patients: an endocrine perspective","volume":"33","author":"M I Khan","year":"2018","journal-title":"J Intensive Care Med"},{"issue":"03","key":"ref7","first-page":"148","article-title":"Critical care hypercalcemia--a hyperparathyroid state","volume":"100","author":"L Lind","year":"1992","journal-title":"Exp Clin Endocrinol"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.33549\/physiolres.933059","article-title":"Hypercalcemia. 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