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Plasma corticoids in the respiratory distress syndrome and in normal infants
Insights
Neonatal infants with severe respiratory distress syndrome (RDS) show elevated plasma corticoid levels, especially those who did not survive. This indicates a stress response in neonates, though milder illness may only slightly alter corticoid levels.
Area of Science:
- Neonatal Medicine
- Endocrinology
- Pediatric Critical Care
Background:
- Respiratory distress syndrome (RDS) is a common neonatal condition.
- Plasma corticoid levels are indicators of physiological stress.
Purpose of the Study:
- To investigate plasma corticoid levels in neonatal infants with RDS.
- To compare corticoid levels between infants with RDS, surviving RDS infants, and healthy controls.
- To explore the correlation between plasma corticoids and acid-base status in fatal RDS cases.
Main Methods:
- Serial plasma samples were collected from 16 infants with RDS and 44 healthy neonates.
- Plasma corticoid concentrations were measured.
- Simultaneous measurements of pH, PCO2, PO2, and HCO3- were performed in five fatal RDS cases.
Main Results:
- Infants with fatal RDS exhibited significantly higher median plasma corticoid levels compared to survivors and healthy controls.
- Surviving RDS infants had statistically higher corticoid levels than healthy controls, but the difference was marginal.
- A poor correlation was observed between plasma corticoids and acid-base parameters in most fatal RDS cases.
Conclusions:
- Neonatal infants can mount an appropriate plasma corticoid response to severe physiological stress.
- Milder forms of illness in neonates may result in minimal alterations in plasma corticoid concentrations.
- Plasma corticoid levels may serve as a stress marker in neonatal RDS, with higher levels potentially indicating poorer outcomes.
Abstract:
Serial plasma samples for corticoid determination were obtained during the neonatal period in 16 infants with RDS (eight of whom died) and 44 healthy babies. The median corticoid level in the eight infants with RDS who was considerably higher than that of patients with RDS who survived, or the normal babies. The median corticoid level in the surviving RDS infants was statistically greater than that of the normal controls, but the actual difference was only 1.9 mug/100 ml. Simultaneous pH, PCO2, PO2, HCO3- and corticoid measurements were obtained serially in five patients with fatal RDS. However, the correlation between plasma corticoids and the acid-base determination was poor in all but one infant. It is concluded that infants are able to respond to severe physical stress in the neonatal period with an appropriate rise in plasma corticoid concentration, but lesser degrees of illness may cause only minimal changes in corticoid levels.