INTRODUCTION

Metabolic and endocrine derangements constitute a component of all forms of critical illness and are often manifested by their effects on target organs such as the heart or kidneys. In addition, many acute problems such as shock, infections or trauma can precipitate endocrine dysfunction. Endocrine and metabolic disorders are not usually assessed by highly technological monitoring devices often used in the critically ill. Rather, they are evaluated by relatively simple skills such as physical assessment and the interpretation of common tests performed on blood and urine specimens.

The goal of this seminar is to integrate the complex pathophysiology of common endocrine disorders such as diabetic ketoacidosis, diabetes insipidus, and others with their clinical manifestations and bedside relevance in the critically ill. In addition, a heavy emphasis on metabolic derangements such as calcium, phosphorus, magnesium imbalances, and regulation of plasma osmolality will also be discussed.