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Perioperative care of congenital adrenal hyperplasia - a disparity of physician practices in Canada.


ABSTRACT: Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is the most common cause of primary adrenal insufficiency in children. Current guidelines recommend the use of perioperative stress dose (supraphysiologic) glucocorticoids for children with CAH undergoing anesthesia, although a perceived difference in practice patterns among Canadian pediatric subspecialists prompted an assessment of perioperative glucocorticoid administration.We performed a cross-sectional survey of Canadian Pediatric Anesthesia Society (CPAS) and Canadian Pediatric Endocrine Group (CPEG) members via membership email lists to assess reported practice patterns to select clinical scenarios.Responses were collected from 49 anesthesiologists and 37 pediatric endocrinologists. Less than half of anesthesiologists reported they would provide stress dose corticosteroids for patients undergoing cystoscopy while a significant majority of pediatric endocrinologists reported they would recommend stress dose corticosteroid administration (45% vs 92% respectively, p 

SUBMITTER: Nour MA 

PROVIDER: S-EPMC6131860 | biostudies-other | 2018

REPOSITORIES: biostudies-other

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Perioperative care of congenital adrenal hyperplasia - a disparity of physician practices in Canada.

Nour Munier A MA   Gill Hardave H   Mondal Prosanta P   Inman Mark M   Urmson Kristine K  

International journal of pediatric endocrinology 20180910


<h4>Background</h4>Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is the most common cause of primary adrenal insufficiency in children. Current guidelines recommend the use of perioperative stress dose (supraphysiologic) glucocorticoids for children with CAH undergoing anesthesia, although a perceived difference in practice patterns among Canadian pediatric subspecialists prompted an assessment of perioperative glucocorticoid administration.<h4>Methods</h4>We performed a  ...[more]

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