Comparison between low- and standard-dose ACTH tests in premature infants at risk for chronic lung disease.
In order to find a sensitive method to evaluate adrenocortical function in premature infants, we compared low- (0.5 microg/1.73 m(2)) and standard-dose (250 microg/1.73 m(2)) adrenocorticotropin tests (LD- and SD-ACTH) in 12 very-low-birth-weight infants before and 2 days after the end of dexamethasone therapy (duration 9-14 days) for chronic lung disease. Basal serum cortisol levels were inappropriately low in several infants already before dexamethasone therapy (median 190, range 60-357 nmol/l). The 95% confidence intervals of mean serum cortisol levels at 20 min were equal in LD- and SD-ACTH, while at 60 min, the low-dose gave a clearly lower response than the standard-dose test. The LD-ACTH can be used in premature infants as in older children and adults, but the criteria for adrenocortical insufficiency need to be defined.
Nykänen
P
P
Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland. paivi.nykanen@uku.fi
Heinonen
K
K
Voutilainen
R
R
D000324:Adrenocorticotropic Hormone / Q000008:administration & dosage*; D002908:Chronic Disease; D003907:Dexamethasone / Q000627:therapeutic use; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007231:Infant, Newborn; D007234:Infant, Premature; D007700:Kinetics; D008171:Lung Diseases / Q000175:diagnosis* / Q000188:drug therapy; D012307:Risk Factors
D005938:Glucocorticoids; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone