Serum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.
Affiliation
Department of Paediatrics and Newborn Medicine, Coombe Women and Infants, University Hospital, Dublin, Ireland. miletinj@yahoo.comIssue Date
2012-02-01T10:57:57ZMeSH
Adrenal Insufficiency/bloodBiological 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
Metadata
Show full item recordCitation
J Perinatol. 2010 Aug;30(8):522-6. Epub 2010 Mar 25.Journal
Journal of perinatology : official journal of the California Perinatal, AssociationDOI
10.1038/jp.2010.26PubMed ID
20336081Abstract
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
engISSN
1476-5543 (Electronic)0743-8346 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1038/jp.2010.26