title: Evaluation of endocrine function in children admitted to pediatric intensive care unit.
abstract: BACKGROUND
  Although studied widely in adulthood, little is known about endocrinological disorders during critical illnesses in childhood. The aims of this study were to define the endocrinological changes in patients admitted to pediatric intensive care unit (PICU) and to identify their effects on prognosis.
  
  
  METHODS
  Forty patients with a mean age of 5.1 years admitted to PICU were enrolled in the study. Blood samples were taken at admission and at 24 and 48 h to measure cortisol, adrenocorticotropic hormone (ACTH), prolactin, growth hormone (GH), GH binding protein (GHBP), insulin-like growth factor-binding protein-3 (IGFBP-3) and interleukin-6 (IL-6). The severity of the patient's condition was assessed using pediatric risk of mortality (PRISM) and pediatric logistic organ dysfunction (PELOD) scores.
  
  
  RESULTS
  PRISM and PELOD scores were significantly higher in non-survivors. Cortisol, ACTH, prolactin, GH, GHBP, IGFBP-3 and IL-6 were not significantly different between the survivors and non-survivors. There was a negative correlation between baseline IGFBP-3 and PRISM scores. A positive correlation was seen between cortisol level at 24 h and PRISM score. On multivariate linear regression analysis, PRISM score was best explained by ACTH and cortisol at 24 h. A positive weak correlation was detected between IL-6 at 24 h and PELOD scores.
  
  
  CONCLUSIONS
  Although there was no difference between survivors and non-survivors regarding the studied endocrine parameters, there were associations between cortisol, ACTH, IL-6 and IGFBP-3 and risk assessment scores, and, given that these scores correlated with mortality, these parameters might be useful as prognostic factors.
authors.affiliation: Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey.
authors.forename: Banu Küçükemre
authors.initials: BK
authors.lastname: Aydın
authors.forename: Demet
authors.initials: D
authors.lastname: Demirkol
authors.forename: Firdevs
authors.initials: F
authors.lastname: Baş
authors.forename: Umit
authors.initials: U
authors.lastname: Türkoğlu
authors.forename: Alkın
authors.initials: A
authors.lastname: Kumral
authors.forename: Metin
authors.initials: M
authors.lastname: Karaböcüoğlu
authors.forename: Agop
authors.initials: A
authors.lastname: Cıtak
authors.forename: Feyza
authors.initials: F
authors.lastname: Darendeliler
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D002675:Child, Preschool; D004702:Endocrine Glands / Q000503:physiopathology*; D005260:Female; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D015278:Intensive Care Units, Pediatric; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D015850:Interleukin-6; D000324:Adrenocorticotropic Hormone
keywords: adrenocorticotropic hormone; cortisol; growth hormone; pediatric intensive care; prolactin