Evaluation of adrenal function in critically ill children

The activation of the hypothalamic-pituitary-adrenal axis in response to critical illness and the resulting release of cortisol from the adrenal cortex are essential to stress adaptation and maintenance of cardiovascular homeostasis. However, there is no consensus on adequate adrenal response to critical illness.

Balbão et al., conducted  a prospective study  to evaluate adrenal function in critically ill children compared with a control group of healthy children by measuring  salivary cortisol and serum total cortisol at baseline and after ACTH stimulation test. Another objective of their study was to  verify the association of adrenal function with clinical outcome.

The study shows that adrenal insufficiency defined by the ‘delta criterion’ was not associated with outcome. The study demonstrates that it is feasible to perform salivary cortisol measurements in critically ill paediatric patients.

Read full article published in Balbão et al. (2014) Clinical Endocrinology, Vol 81, pp 559-565. DOI:10.1111/cen.12444.