Salivary Cortisol Estimation to Assess Adrenal Status in Children with Fluid Unresponsive Septic Shock.
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Date
2013-07
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Abstract
We evaluated the adrenal status by estimating baseline and ACTH stimulated salivary
cortisol in 51 children with fluid unresponsive septic shock at 30 and 60 minutes, and basal
salivary cortisol (9-11 am) in 79 healthy children. The baseline salivary cortisol (median,IQR)
among patients (19.8, 7.2-42.4 nmol/L) was higher than healthy children (2.6, 1.3-7.6 nmol/L)
(P=0.001). Non-survivors and those with catecholamine refractory shock had higher baseline
cortisol level, though difference was statistically insignificant. Absolute adrenal insufficiency
(baseline salivary cortisol <1.3nmol/L) was diagnosed in 8 (15.7%) patients. Relative adrenal
insufficiency (rise in cortisol level above baseline value after stimulation <25nmol/L) was
observed in 68.6% of all patients; 71.9% among non-survivors, and in 71.4% patients with
catecholamine refractory shock. Salivary cortisol estimation appears to be feasible in
children with septic shock. Relative adrenal insufficiency is common in these children.
Description
Keywords
Salivary cortisol, Fluid unresponsive septic shock, Adrenal insufficiency
Citation
Singh S N, Rathia S K, Awasthi Shally, Singh Anita, Bhatia Vijaylaxmi. Salivary Cortisol Estimation to Assess Adrenal Status in Children with Fluid Unresponsive Septic Shock. Indian Pediatrics. 2013 July; 50(7): 681-684.