Critical illness-related corticosteroid insufficiency in cardiogenic shock

Abstract

Anaesthesia for massive retrosternal thyroidectomy in a tertiary referral centre Editor-We read the publication by Dempsey and colleagues 1 with interest. We have a few questions about the report which we hope the authors can clarify.First, what events actually occurred surrounding the one case of failed intubation. If we followed correctly, they were the only patient undergoing an inhalation induction. What prompted the change from i.v. induction? Do the authors think that this influenced events?Secondly, regarding laryngoscopy and intubation, was there a poor view or was the view good but passing the tube impossible? Does the case in Table 3 marked as failed under laryngoscopy equate to a grade 4 view and is this the case in question?Thirdly, in the discussion, the authors make reference to a low incidence of difficult intubation. Is one in 20 (5%) not regarded as a high incidence?We would be grateful for more information regarding these difficult cases, so we can learn further from others' experience.

Critical illness - related corticosteroid insufficiency in patients after cardiac surgery and cardiologic emergencies

“…Проблема диагностики ННКС в настоящее время далека от окончательного разрешения. В то время как некоторые исследователи предлагают диагностические алгоритмы ННКС [16], другие авторы весьма скептически оценивают возможности объективной диагностики этого состояния [22].…”