The endocrinology of the critically ill

: Critical illness is characterized by one or more failing organs. Hormonal regulation of metabolism changes during the course of critical illness and is related to the severity of disease. Hormonal effects and inflammatory reactions are important and interrelated factors with respect to outcome. Recent large scale insulin infusion studies have demonstrated beneficial effects on both the immune response and coagulation systems. Future research will show whether further hormonal substitution can reveal similar results.