Until recently, it was common practice in the management of severe postoperative shock for surgeons to use adrenal cortical extracts in the hope that a lack of these substances might be an etiological or contributing factor in the production of shock.1 A combination of two factors has been responsible for the common failure of such an approach: first, the relative rarity of adrenal cortical insufficiency in the etiology of shock, and, second, administration of inadequate doses of hormones. Knowledge of the physiology of adrenal insufficiency gained during the last five years has made it possible to base corticosteroid therapy on a firmer foundation.2 Also, the concept of stress stemming from the extensive work of Selye3 has helped to reveal the importance of the adrenal cortex in the body's response to a host of stressful situations, including major or minor surgery. Much has been learned from the study
Adams R, Siderius N. POSTOPERATIVE ACUTE ADRENAL CORTICAL INSUFFICIENCY. JAMA. 1957;165(1):41–44. doi:10.1001/jama.1957.72980190001010
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