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Adrenal crisis and acute adrenal insufficiency for full assessment and management guidelines of an unwell child with adrenal insufficiency.
Children with known or suspected adrenal insufficiency require increased doses of hydrocortisone in the peri-operative period. This is required to replace the body's usual 'stress' cortisol response in such a scenario; if adequate replacement is not given, an adrenal crisis may be precipitated.
*The doses outlined equate to approximately 50-75mg/m2 as a stat dose initially, followed by 50-75 mg per m2/day divided in 4 doses (6 hourly). These doses will also cover the patient's mineralocorticoid replacement over this dosing period.
Please discuss with the endocrinology team who will advise on individual dosing schedules.
Last updated May 2011