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Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery
09:47

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Published on: June 2, 2022

Adrenal function in newborns undergoing surgery.

E F Fernandez1, R Montman, K L Watterberg

  • 1Division of Neonatology, Department of Pediatrics, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM 87131, USA. efernandez@salud.unm.edu

Journal of Perinatology : Official Journal of the California Perinatal Association
|March 19, 2010
PubMed
Summary
This summary is machine-generated.

Pre-surgical cortisol levels in newborns do not predict illness severity after surgery. However, lower cortisol values were linked to vasopressor use in critically ill infants.

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Area of Science:

  • Neonatalogy
  • Endocrinology
  • Pediatric Surgery

Background:

  • The hypothalamic-pituitary-adrenal (HPA) axis is crucial for stress response.
  • Assessing HPA axis function in critically ill newborns undergoing surgery is important for understanding their physiological status.

Purpose of the Study:

  • To measure cortisol and adrenocorticotropic hormone (ACTH) levels in newborns admitted to the NICU within 48 hours before surgery.
  • To examine the relationship between these hormonal values and clinical illness severity before and after surgery.

Main Methods:

  • A prospective observational study involving 25 newborn infants (<44 weeks postmenstrual age) admitted to the NICU.
  • Measured baseline and ACTH-stimulated cortisol concentrations within 48 hours pre-surgery.
  • Assessed illness severity using the Score for Neonatal Acute Physiology (SNAP) and vasopressor use.

Main Results:

  • Median baseline cortisol was 7.1 mcg/100ml and ACTH-stimulated cortisol was 40.4 mcg/100ml.
  • Preterm infants showed significantly lower ACTH-stimulated cortisol levels compared to term infants.
  • No correlation was found between cortisol values and pre/post-surgical illness severity scores or SNAP changes.
  • Infants requiring vasopressors had lower ACTH-stimulated cortisol values.

Conclusions:

  • Presurgical cortisol levels do not predict clinical response to surgical stress in newborns based on illness severity scores.
  • Lower cortisol values were associated with perioperative vasopressor therapy.
  • Further research is needed to clarify the role of cortisol in neonatal surgical outcomes and the potential benefits of glucocorticoid supplementation.