Keywords
hormonal status
steroids
newborn
critical condition
steroids
newborn
critical condition
How to Cite
1.
Aleksandrovich Y.S., Fomin S.A., Pshenisnov K.V. Features of the hormonal status at newborns in critical condition. Article. Annals of Critical Care. 2019;(4):106-112. doi:10.21320/1818-474X-2019-4-106-112
Statistic
Abstract Views: 146
PDF_2019-4_106-112 (Russian) Downloads: 17
HTML_2019-4_106-112 (Russian) Downloads: 418
PDF_2019-4_106-112 (Russian) Downloads: 17
HTML_2019-4_106-112 (Russian) Downloads: 418
Statistic from 01.07.2024
Language
Most reader
-
2042
-
1161
-
735
-
621
-
544
Social Networks
Abstract
Background. Changes in hormonal status are the main factors in the implementation of all mechanisms of compensation and resistance protection, which is especially relevant for newborns in critical condition.
Objectives. Study the features of hormonal status in newborns with congenital malformations in need of surgery and intensive care.
Materials and methods. 23 newborns with congenital malformations were examined, including 10 boys and 13 girls. Gestation age was 39.3 (38–40) weeks Among the congenital malformations, right-sided false diaphragm hernia (25 %), esophageal atresia with tracheopisophageal fistula (20 %), Ledd syndrome (10 %) and omphalocele (15 %) dominated. Cystic doubling of the blind intestine (5 %), Girschprung disease (5 %), ovarian cyst (15 %) and retroperitoneal lymphangioma (5 %) were also detected. The condition of children at birth was more severe, as evidenced by the low Apgar score, which at the first minute was 7.5 (6–8) and at the fifth 8.0 (7–9) points.
Results. Children with congenital malformations were found to have higher concentrations of cortisone, cortisol, aldosterone and lower 17-hydroxyprogesterone, 17-hydroxypregnenolone, DGEA and progesterone, which were statistically significant (p < 0.05). The concentration of cortisol and aldosterone was significantly higher in the first stage of the study, most likely due to the presence of stress and massive fluid therapy (p = 0.001). It was found that upon admission to the intensive care and intensive care unit, patients had sufficiently high concentrations of all steroid hormones, with the concentration of cortisol and cortisone reaching a maximum at the third stage of the study.
Conclusion. In children with congenital malformations subjected to rapid treatment and intensive care, there is an increase in the concentration of cortisol and cortisone with a simultaneous decrease in the level of their precursors, which is a marker of stress caused by the main disease and therapeutic effects.
References
- Шабалов Н.П. Неонатология. Учебное пособие в двух томах. М.: ГЭОТАР-Медиа, 2019. [Shabalov N.P. Neonatologiya (Neonatology) Uchebnoe posobie v dvuh tomah. M.: GEOTAR-Media, 2019. (In Russ)]
- Шабалов Н.П. Детские болезни. Учебник для вузов. СПб.: Питер, 2019.[Shabalov N.P. Detskie bolezni (Children disease) Uchebnik dlya VUZov. SPb.: Piter, 2019. (In Russ)]
- Селье Г. Стресс без дистресса. М.: Прогресс, 1979. [Sele G. Stress bez distressa (Stress without Distress). M.: Progress, 1979. (In Russ)]
- Hallman M. The story of antenatal steroid therapy before preterm birth. Neonatology. 2015; 107(4): 352–357. DOI: 10.1159/000381130.
- Dasgupta S., Jain S.K., Aly A.M. Neonatal Hypotension, the Role of Hydrocortisone and Other Pharmacological Agents in its Management. J Pediatr Child Care. 2016; 2(1): 08.
- Anand K.J., Brown M.J., Causon R.C., et al. Can the human neonate mount an endocrine and metabolic response to surgery? J Pediatr Surg. 1985; 20(1): 41–48.
- Crawford J.H., Hull M.S., Borasino S., et al. Adrenal insufficiency in neonates after cardiac surgery with cardiopulmonary bypass. Paediatr Anaesth. 2017; 27(1): 77–84. DOI: 10.1111/pan.13013
- Abdel Mohsen A.H., Taha G., Kamel B.A., Maksood M.A. Evaluation of aldosterone excretion in very low birth weight infants. Saudi J Kidney Dis Transpl. 2016; 27(4): 726–732. DOI: 10.4103/1319-2442.185234
- Talge N.M., Neal C., Glover V. Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? Journal of Child Psychology and Psychiatry. 2007; 48(3–4): 245–261. DOI: JCPP1714[pii]10.1111/j.1469–7610.2006.01714.x
- Mörelius E., He H.G., Shorey S. Salivary cortisol reactivity in preterm infants in neonatal intensive care: an integrative review. Int J Environ Res Public Health. 2016; 13(3). pii: E337. DOI: 10.3390/ijerph13030337
- Hillman N.H., Kallapur S.G., Jobe A.H. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol. 2012 Dec;39(4):769–783. DOI: 10.1016/j.clp.2012.09.009
- Albrecht E.D., Pepe G.J. Placental steroid hormone biosynthesis in primate pregnancy. Endocr Rev. 1990; 11(1): 124–150.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.