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New insight of adrenal responses in premature neonates versus full term neonates in critical care setting

Suzan Abd Razik, Heba Ezzat Hashem, Zakaria H Ibrahim, Wafaa Osman Ahmed*, Ahmed A Obaid, Hanan M Abd El-Lateef

Objectives: This prospective observational study recruited 60 neonates divided into 3 groups (A) 30 critical ill neonates with septic shock on inotropic support, group(B)15 patients with sepsis with no inotropic support and control group (C) (n=15). Methods: Clinical and laboratory assessment of the neonates for adrenal insufficiency and measuring diurnal ACTH and serum diurnal and nocturnal cortisol level. Results: Serum cortisol was significantly higher in group A (58.3 ± 24.1) and B (44.6 ± 18.7), while it was lower in group C (15.3 ± 5.1). Group A had lower blood pressure despite higher cortisol level as compared to groups B and C, that was improved after vasopressor drug administration and the full term neonates showed better response to inotropic support as compared to preterm neonates. Conclusion: Relative adrenal insufficiency occurs in neonate in sepsis and septic shock and it is especially evident among premature babies.