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OP-077 Retrospective evaluating of the patients with critical illnes-related corticosteroid insufficiency in pediatric intensive care unit
  1. Gökhan Kiğılı1,
  2. Esra Deniz Papatya Çakır1,
  3. Nihal Akçay2,
  4. Esra Şevketoğlu1
  1. 1Bakırköy Dr.Sadi Konuk Research and Training Hospital
  2. 2Kanuni Sultan Süleyman Training and Research Hospital


Aim In this study, we aimed to evaluate the factors affecting the mortality and prognosis of the patients with critical illness-related corticosteroid insufficiency in our pediatric intensive care unit.

Material and Method This study included a total number of 79 patients with critical illness-related corticosteroid insufficiency in the PICU of our hospital in between January 2014 and December 2019. The age, gender, hospitalization and comorbidity status of the patients;as well as extracorporeal treatments that were applied, their PRISM scores, their sources of infection, if there were any, the kind of the microorganisms that grew on the cultures, the intensive care and total hospital stay status, the reason for hydrocortisone therapy and the exact time to initiate the treatment, the initial doses and schemes to adjust the doses, the duration of mechanical ventilation period and the laboratory values were transferred directly from the clinical file records to our database. The serum lactate, ScvO2, PELOD, OFI and VIS and blood pressure values were recorded on the day the patients were diagnosed with critical illness-related corticosteroid insufficiency and these values were recorded at a certain interval according to the hydrocortisone treatment schedule.

Results Of the 79 patients included in the study,41(51%) were boys and 38(49%) were girls.55 of them(69.6%) were lost.48(60.8%) of the patients had comorbidies. Out of the patients with critical illness-related corticosteroid insufficiency;58(73.4%) of them were classified to be in septic shock,16(%20,3) were in cardiogenic shock and 5(%6,3) of them were classified as others. After initiating the hydrocortisone treatment, there was an increase in the mean systolic, diastolic and arterial pressures, and a decrease in the mean OFI and VIS scores, which were statistically significant.

Conclusions Hydrocortisone was found to be effective in increasing mean arterial blood pressures and reducing OFI and VIS. There were no relationship in between hydrocortisone, ScvO2, lactate and PELOD. The increased lactate levels, PELOD, the PELOD mortality percentage and VIS values were associated with mortality at 0 and 24th hours. We believe that there is a need for more comprehensive and multidisciplinary, prospective clinical studies about critical illness-related corticosteroid insufficiency.

  • pediatric intensive care unit
  • critical illness
  • adrenal insufficiency
  • cortisol
  • hydrocortisone

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