Abstract
To evaluate the controversial role of adrenocortical hormones in RDS, plasma cortisol (F) and urinary excretion of tetrahydrocortisol (THF), tetrahydrocortisone (THE), and aldosterone were determined by specific radiolmmunoassays during the first 8-10 days of life in 10 normal premature infants (group I) and in 10 premature infants with RDS (group II). In group I plasma F decreased from 15.8 ± 5.4/μg/100 ml on the 1st day to 4.1 ± 0.8 /μg/100 ml after 1 week. Urinary THF (0.005 - 0.08 mg/m2/24 h) and THE (0.01 - 0.1 mg/ m2/24 h) were low when compared with normal values of older children (THF 0.3 - 2.5 mg/m2/24 h, THE 0.3 - 3.0 mg/m2/24 h). In group II plasma F rose from 15.2 ± 1.7 μg/100 ml to 27.2 ± 8.7 μg/100 ml on the 7th day. Urinary THF and THE in group II were 2–3 times higher than in group I. Aldosterone excretion was high, but varied widely (1.0 - 60.0 μg/m2/24 h) in group I and II, the normal adult values being 2.0 - 12.0 μg/m2/24 h. No correlation to the sodium balance could be detected. There is no evidence for a postnatal adrenal insufficiency in premature infants with RDS. The low urinary THF and THE in the presence of normal or elevated plasma F levels can be explained by different metabolic pathways in premature infants.
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Rauh, W., Manz, F., Wille, L. et al. 46: Adrenal function in premature infants with respiratory distress syndrome (RDS). Pediatr Res 10, 879 (1976). https://doi.org/10.1203/00006450-197610000-00044
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DOI: https://doi.org/10.1203/00006450-197610000-00044