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

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    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
    Issue Date
    2012-02-01T10:57:57Z
    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
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    Metadata
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    Citation
    J Perinatol. 2010 Aug;30(8):522-6. Epub 2010 Mar 25.
    Journal
    Journal of perinatology : official journal of the California Perinatal, Association
    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
    ISSN
    1476-5543 (Electronic)
    0743-8346 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1038/jp.2010.26
    Scopus Count
    Collections
    Coombe Women & Infants University Hospital

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