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Stress dose steroids
From WikEM
Revision as of 05:09, 7 May 2017 by Rossdonaldson1 (Talk | contribs)
Emergency corticosteroid suplementation in patients taking exogenous corticosteroids
Category | Initial | Subsequent |
Minor procedure or surgery under local anesthesia (eg, inguinal hernia repair) | No extra supplementation is necessary | Continue normal dosing |
Moderate surgical stress (eg, lower extremity revascularization, total joint replacement) | 50 mg hydrocortisone IV | 25 mg of hydrocortisone every eight hours for 24 hours. Resume usual dose thereafter. |
Major surgical stress (eg, esophagogastrectomy, total proctocolectomy, open heart surgery) | 100 mg hydrocortisone IV | 50 mg every eight hours for 24 hours. Taper dose by half per day to maintenance level. |