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Salivary cortisol is not associated with dexamethasone response in preterm infants with evolving bronchopulmonary dysplasia

  • Tamorah Lewis,
  • Erik A. Jensen,
  • Sherry Courtney,
  • Jonathan Slaughter,
  • Matthew J. Kielt,
  • Narayan Prahbu Iyer,
  • Cheri Gauldin,
  • Christopher Nitkin,
  • Hung-Wen Yeh,
  • William Truog

摘要

Objective

Short-term treatment efficacy of systemic dexamethasone (DEX) in preterm infants with bronchopulmonary dysplasia (BPD) is highly variable. Our objective was to assess if salivary cortisol may serve as a reliable biomarker of steroid response.

Study design

Multi-site prospective observational cohort study. Salivary cortisol was measured before and after DEX treatment. Respiratory Severity Score (RSS) quantified clinical response.

Results

Fifty-four infants with median (inter-quartile range) gestational age of 25.1 (24.1,26.5) weeks initiated DEX at 30 (23,48) days’ postnatal age. Median baseline and post-treatment cortisol levels were 0.3 (0.2,0.6) μg/dl; 8.3 (5.5,16.5) nmol/L and 0.2 (0.1,0.3) μg/dl; 5.5 (2.8,8.3) nmol/L, respectively. RSS values decreased by a median of 3.1(1.6,5.0) Change in RSS did not correlate with baseline cortisol or change in cortisol levels.

Conclusion

In this first study to assess salivary cortisol as a biomarker for DEX response in BPD, salivary cortisol did not predict dexamethasone response.