2025 Multiprofessional Critical Care Review: Adult Online-Endocrine Emergencies

Video Transcription

Video Summary

This lecture reviews critical endocrine emergencies including diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), hypoglycemia, thyroid storm, myxedema coma, adrenal insufficiency, diabetes insipidus, and pheochromocytoma. DKA involves insulin deficiency leading to hyperglycemia, acidosis with an elevated anion gap, and ketosis; treatment centers on isotonic saline, insulin infusion, and potassium replacement, monitoring anion gap resolution rather than glucose levels. Euglycemic DKA can occur in patients on SGL-2 inhibitors. HHS involves extreme hyperglycemia without ketoacidosis and has higher mortality. Hypoglycemia causes vary, treated primarily with glucose and sometimes glucagon or octreotide. Thyroid storm requires blocking hormone synthesis (PTU), beta-blockade, iodine, and steroids, while myxedema coma involves thyroid hormone replacement and supportive care. Adrenal insufficiency presents with hypotension, hyponatremia, and hyperkalemia, managed with fluids and hydrocortisone. Diabetes insipidus features polyuria and hypernatremia treated with vasopressin. Pheochromocytoma causes hypertensive crises treated with alpha blockers followed by beta blockers and surgery.

Keywords

diabetic ketoacidosis

hyperglycemic hyperosmolar state

hypoglycemia

thyroid storm

adrenal insufficiency

pheochromocytoma

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