Endocrine Issues in Neurocritical Care

The endocrine system is an integral organ system that maintains homeostasis in humans. Critical illness causes dysregulation of the endocrine system and threatens to disrupt human hormonal balance. Neurologically injured patients are at particularly high risk for various endocrinopathies depending on their individual insults and comorbidities. Hormonal imbalances seen in the neurocritically ill may vary depending on the acute or chronic phase of critical illness. Emerging therapeutic hormonal measures continue to be investigated in order to reverse the deleterious effects of hormonal dysregulation, particularly in the chronic phase of critical illness. Neurointensivists should be aware of the various perioperative endocrine abnormalities and the associated ICU polypharmacy that also causes endocrine disorders. Recognition of these causes may lead to earlier interventions.