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Adrenocortical Dysfunctions in Neonatal Septic Shock
Vivek Bhat1, Shiv Sajan Saini2, Naresh Sachdeva3
1Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Indian Journal of Pediatrics
|January 29, 2022
Summary
Neonatal septic shock can cause adrenal insufficiency, affecting 27% of newborns. This condition involves low cortisol levels, impacting the body's stress response.
Area of Science:
- Neonatology
- Endocrinology
- Pediatric Critical Care
Background:
- Neonatal septic shock is a critical condition with high mortality.
- Adrenal insufficiency is a potential complication of septic shock in neonates.
- Accurate assessment of adrenal function is crucial for timely management.
Purpose of the Study:
- To determine the prevalence of adrenal insufficiency in neonates with septic shock.
- To differentiate between absolute and relative adrenal insufficiency.
- To evaluate baseline and stimulated cortisol levels in this population.
Main Methods:
- Prospective study of 30 neonates with septic shock.
- Measurement of baseline serum cortisol and adrenocorticotropin (ACTH) levels.
- ACTH stimulation test with repeat cortisol measurements after 30 minutes.
Main Results:
- Prevalence of adrenal insufficiency was 27% (95% CI: 12%-46%).
- Six neonates had absolute adrenal insufficiency, and 2 had relative adrenal insufficiency.
- 57% of neonates showed low baseline cortisol with an adequate response to ACTH stimulation.
Conclusions:
- Adrenal insufficiency is a significant concern in neonatal septic shock.
- The study highlights the importance of assessing adrenal function in neonates with sepsis.
- Further research may explore optimal management strategies for adrenal insufficiency in this group.
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