Multiprofessional Critical Care Review: Pediatric 2024 (MCCRCP24ON)-Pediatric Endocrine Issues

Video Transcription

Video Summary

In this lecture, the speaker discusses common endocrine issues encountered in the pediatric intensive care unit (PICU). They cover topics such as diabetic ketoacidosis (DKA), adrenal insufficiency, the renal angiotensin-aldosterone axis, salt and water syndromes, pheochromocytoma, and hypo/hyperthyroidism.<br /><br />In DKA, the speaker explains the three defining elements: hyperglycemia, acidosis, and ketosis. They also describe the consequences of insulin deficiency, which include unrestrained gluconeogenesis, a switch to fatty acids as the primary energy source, and hyperglycemia and hyperosmolality leading to glucosuria and excessive water and electrolyte losses. The speaker outlines the primary interventions for DKA treatment, including fluid resuscitation, insulin administration, rehydration, electrolyte management, investigation of precipitants, and avoiding complications.<br /><br />They then discuss adrenal insufficiency, the renal angiotensin-aldosterone axis, and the three salt and water syndromes (cerebral salt wasting, syndrome of inappropriate antidiuretic hormone excess, and diabetes insipidus). The speaker explains the characteristics, causes, and treatments of each syndrome.<br /><br />Next, they cover pheochromocytoma, a tumor of the adrenal medulla, which is more common in males and can be associated with multiple endocrine neoplasia. Symptoms include hypertension, tachycardia, flushing, and emotional lability. Treatment involves alpha and beta blockade, inhibition of tyrosine hydroxylase, and surgical resection.<br /><br />Finally, the speaker discusses hypo and hyperthyroidism, the sick U thyroid syndrome, and thyroid storm. They explain the mechanisms and treatments for each condition, as well as drugs that can affect thyroid hormone metabolism.<br /><br />Overall, this lecture provides an overview of common endocrine issues encountered in the PICU and their management.

Keywords

endocrine issues

pediatric intensive care unit

DKA

adrenal insufficiency

renal angiotensin-aldosterone axis

salt and water syndromes

pheochromocytoma

hypothyroidism

hyperthyroidism

thyroid storm

insulin deficiency

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