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. 2022 Jan 28;6(3):bvac010. doi: 10.1210/jendso/bvac010

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© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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Figure 1. — Suggested algorithm for perioperative management of Cushing disease. AI, adrenal insufficiency; DI, diabetes insipidus; DST, dexamethasone suppression test; GC, glucocorticoids, HPA, hypothalamic-pituitary-adrenal; I&O, intake and output; IPSS, inferior petrosal sinus sampling; LNSC, late-night salivary cortisol; Na⁺, sodium; SIADH, syndrome of inappropriate antidiuretic hormone; UFC, urinary free cortisol. *See Tables 1 and 2. Adjust antihypertensive and antihyperglycemic regimen proactively if remission is achieved postoperatively. Urine osmolality/specific gravity may be checked daily and/or as needed paired with serum sodium every 6 to 12 hours depending on local protocols.