Serum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.

Hdl Handle:
http://hdl.handle.net/10147/208022
Title:
Serum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.
Authors:
Miletin, J; Pichova, K; Doyle, S; Dempsey, E M
Affiliation:
Department of Paediatrics and Newborn Medicine, Coombe Women and Infants, University Hospital, Dublin, Ireland. miletinj@yahoo.com
Citation:
J Perinatol. 2010 Aug;30(8):522-6. Epub 2010 Mar 25.
Journal:
Journal of perinatology : official journal of the California Perinatal, Association
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/208022
DOI:
10.1038/jp.2010.26
PubMed ID:
20336081
Abstract:
OBJECTIVE: Recent evidence suggests that high cortisol concentrations are associated with increased morbidity and mortality in very low birth weight (VLBW) infants. Neonatal illness severity and mortality risk scores are reliable in predicting morbidity and mortality. The objectives were (i) to assess the correlation between serum cortisol levels and clinical assessment of multi-organ dysfunction/illness severity scores (CRIB II, SNAPPE-II and neonatal multiple organ dysfunction score (NEOMOD)) in first 24 h in VLBW infants and (ii) to assess the relationship between surrogates of end organ blood flow and serum cortisol levels. STUDY DESIGN: A prospective observational cohort study. Neonates with birth weight <1500 g were eligible for enrollment. Echocardiography evaluation of superior vena cava (SVC) flow was carried out in the first 24 h life. Cortisol levels were measured simultaneously and appropriate clinical scores were calculated. RESULT: A total of 54 VLBW neonates were enrolled following parental consent. Two patients were excluded because of congenital malformations. In 14 babies the cortisol value was not simultaneously obtained. The mean birth weight was 1.08 kg, mean gestational age was 27.8 weeks. There was a significant correlation between cortisol and NEOMOD score (P=0.006). There was no correlation between cortisol and CRIB II score (P=0.34), SVC flow (P=0.49) and mean arterial blood pressure respectively (P=0.35). CONCLUSION: There was no correlation between SVC flow and cortisol values or between cortisol and mean blood pressure values. There was a significant correlation between cortisol levels and neonatal organ dysfunction score evaluated suggesting that stressed VLBW infants do mount a cortisol response.
Language:
eng
MeSH:
Adrenal Insufficiency/blood; Biological Markers/blood; Blood Flow Velocity; Gestational Age; Humans; Hydrocortisone/*blood; Hypotension/*blood; Infant, Newborn; *Infant, Very Low Birth Weight; Intensive Care Units, Neonatal; Prospective Studies; *Severity of Illness Index; Vena Cava, Superior/*ultrasonography
ISSN:
1476-5543 (Electronic); 0743-8346 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMiletin, Jen_GB
dc.contributor.authorPichova, Ken_GB
dc.contributor.authorDoyle, Sen_GB
dc.contributor.authorDempsey, E Men_GB
dc.date.accessioned2012-02-01T10:57:57Z-
dc.date.available2012-02-01T10:57:57Z-
dc.date.issued2012-02-01T10:57:57Z-
dc.identifier.citationJ Perinatol. 2010 Aug;30(8):522-6. Epub 2010 Mar 25.en_GB
dc.identifier.issn1476-5543 (Electronic)en_GB
dc.identifier.issn0743-8346 (Linking)en_GB
dc.identifier.pmid20336081en_GB
dc.identifier.doi10.1038/jp.2010.26en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208022-
dc.description.abstractOBJECTIVE: Recent evidence suggests that high cortisol concentrations are associated with increased morbidity and mortality in very low birth weight (VLBW) infants. Neonatal illness severity and mortality risk scores are reliable in predicting morbidity and mortality. The objectives were (i) to assess the correlation between serum cortisol levels and clinical assessment of multi-organ dysfunction/illness severity scores (CRIB II, SNAPPE-II and neonatal multiple organ dysfunction score (NEOMOD)) in first 24 h in VLBW infants and (ii) to assess the relationship between surrogates of end organ blood flow and serum cortisol levels. STUDY DESIGN: A prospective observational cohort study. Neonates with birth weight <1500 g were eligible for enrollment. Echocardiography evaluation of superior vena cava (SVC) flow was carried out in the first 24 h life. Cortisol levels were measured simultaneously and appropriate clinical scores were calculated. RESULT: A total of 54 VLBW neonates were enrolled following parental consent. Two patients were excluded because of congenital malformations. In 14 babies the cortisol value was not simultaneously obtained. The mean birth weight was 1.08 kg, mean gestational age was 27.8 weeks. There was a significant correlation between cortisol and NEOMOD score (P=0.006). There was no correlation between cortisol and CRIB II score (P=0.34), SVC flow (P=0.49) and mean arterial blood pressure respectively (P=0.35). CONCLUSION: There was no correlation between SVC flow and cortisol values or between cortisol and mean blood pressure values. There was a significant correlation between cortisol levels and neonatal organ dysfunction score evaluated suggesting that stressed VLBW infants do mount a cortisol response.en_GB
dc.language.isoengen_GB
dc.subject.meshAdrenal Insufficiency/blooden_GB
dc.subject.meshBiological Markers/blooden_GB
dc.subject.meshBlood Flow Velocityen_GB
dc.subject.meshGestational Ageen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHydrocortisone/*blooden_GB
dc.subject.meshHypotension/*blooden_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.mesh*Infant, Very Low Birth Weighten_GB
dc.subject.meshIntensive Care Units, Neonatalen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.mesh*Severity of Illness Indexen_GB
dc.subject.meshVena Cava, Superior/*ultrasonographyen_GB
dc.titleSerum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.en_GB
dc.contributor.departmentDepartment of Paediatrics and Newborn Medicine, Coombe Women and Infants, University Hospital, Dublin, Ireland. miletinj@yahoo.comen_GB
dc.identifier.journalJournal of perinatology : official journal of the California Perinatal, Associationen_GB
dc.description.provinceLeinster-

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