The low dose synacthen test: experience in well preterm infants.
A pilot study to establish what constitutes a normal response to the low dose synacthen test (using 500 ng/1.73 m2 of ACTH) in well preterm infants was carried out on seven well preterm infants. Previous studies on preterm neonates (using a dose of ACTH of 36 microg/kg) suggest that a normal adrenal response is a peak serum cortisol level of > or =360 nmol/l(24). The minimum peak serum cortisol achieved by our cohort was 358 nmol/l with 6/7 infants achieving more than 360 nmol/l. 71% attained a serum cortisol increment from basal level of > or =200 nmol/l. This pilot study suggests that the criterion used to denote a normal adrenal response in preterm neonates using a dose of 36 microg/kg of ACTH (which is a peak serum cortisol of > or =360 nmol/l) can also be a applied when a physiological dose of ACTH (as used in the low dose synacthen test) is used.
Agwu
J C
JC
Department of Paediatrics, Sandwell and City Hospital, Sandwell and West Birmingham NHS Trust, West Bromich, UK. sagwu22890@aol.com
Bissenden
J
J
D015331:Cohort Studies; D003366:Cosyntropin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007231:Infant, Newborn; D007234:Infant, Premature
D003366:Cosyntropin; C006418:adrenocorticotropin zinc; D006854:Hydrocortisone