Stress hormones and posttraumatic stress symptoms following paediatric critical illness: an exploratory study

Area of Science:

• Pediatric endocrinology
• Neuroendocrinology
• Child psychology

Background:

• Pediatric intensive care unit (PICU) admission can impact child development.
• Cortisol regulation is crucial for stress response and overall health in children.
• Understanding long-term physiological effects like cortisol regulation post-PICU is important for recovery.

Purpose of the Study:

• To investigate basal cortisol regulation in children 3-6 months after PICU admission.
• To explore the relationship between post-traumatic stress symptoms and cortisol levels in these children.
• To identify potential predictors of psychological distress following critical illness.

Main Methods:

• A case-control study comparing 47 children recently discharged from PICU with 56 healthy controls.
• Salivary cortisol was measured three times daily over two weekdays.
• Post-traumatic stress symptoms were assessed using the Impact of Events Scale-8 (IES-8).

Main Results:

• No significant differences in basal cortisol concentrations were found between PICU survivors and controls.
• A positive association was observed between post-traumatic stress symptoms and evening cortisol levels in the PICU group.
• Evening cortisol was a modest independent predictor of IES-8 scores, alongside septic illness and pre-morbid health.

Conclusions:

• Paediatric critical illness does not seem to cause significant long-term alterations in basal cortisol regulation.
• A potential link exists between evening cortisol levels and post-traumatic stress symptoms, warranting further investigation.
• Cortisol regulation may be influenced by factors beyond critical illness itself, including pre-existing health and acute illness severity.