Endocrine Emergencies

Until recently, there were no other specialties in medicine so uncomfortable with each other and hence so isolated than Endocrinology and Critical Care Medicine. Fortunately, the two 'alien' disciplines have recently joined forces in successful attempts to perform high quality research in order to clarify the unknown. By integrating the two, new experimental and clinical data on the complex endocrine and metabolic derangements accompanying non-endocrine severe illnesses came available which generated important novel insights with relevant clinical implications. In addition, the state of the art diagnosis and management of primary endocrine diseases that represent life-threatening situations leading to ICU admission has been updated. This issue of "Endocrinology and Metabolism Clinics of North America" aims at compiling all these new findings into one volume, hereby becoming the first compilation of interest to both disciplines, Endocrinology and Critical Care Medicine. The first part deals with the classical life-threatening illnesses caused by primary endocrine diseases such as thyrotoxicosis, hypothyroidism, pheochromocytoma, severe hyper- end hypoglycemia, acute adrenal crises.
The second part of the issue looks at endocrinology from the ICU side, starting with a general overview of the dynamic neuroendocrine and metabolic stress responses in the condition of intensive care-dependent, non-endocrine critical illness. Alterations within several of the endocrine axes briefly touched upon in the overview chapter are then further discussed in detail in the following chapters: critical illness induced alterations within the growth hormone axis, the thyroid axis and the pituitary adrenal axis, changes in catecholamines, glucose control and salt and water metabolism. This last chapter on salt and water disturbances bridges both the endocrine and non-endocrine causes and their specific approaches.