Relative Adrenal Insufficiency in Preterm Very Low Birth Weight Infants With Shock

January 13, 2015 updated by: M. Jeeva Sankar, All India Institute of Medical Sciences, New Delhi

Basal and Stimulated Cortisol Levels in Preterm Very Low Birth Weight Infants With and Without Shock: A Cross-sectional Study

The objective of this study is to estimate the prevalence of relative adrenal insufficiency in preterm very low birth weight infants with and without shock.

Study Overview

Status

Completed

Conditions

Detailed Description

Till date, no studies are available that have evaluated the incidence of relative adrenal insufficiency in preterm very low birth weight (VLBW) infants with shock. The focus had been on stable preterm and critically ill preterm infants. Given that steroid treatment improves blood pressure and stabilizes cardiovascular status in preterm infants with volume and pressor-resistant hypotension,it becomes essential to examine the incidence of adrenal insufficiency in this cohort (rather than a broad group of critically ill preterm infants). Moreover, there are no studies on adrenal function in Indian neonates.

The purpose of this study is to compare the levels of basal and stimulated (using low dose [1µg/k] ACTH) cortisol levels in preterm (28-34 weeks gestation) very low birth weight (birth weight 750 gm to 1500 gm) infants with shock in the first week of life requiring vasopressor therapy and matched (gestation, birth weight, postnatal age-matched) hemodynamically stable infants ('control group').

Study Type

Observational

Enrollment (Actual)

39

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Delhi
      • New Delhi, Delhi, India, 110029
        • All India Institute of Medical Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

No older than 1 week (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

Preterm (28 to 34 week gestation) very low birth weight (birth weight 750-1500grams) infants born at AIIMS

Description

Inclusion Criteria:

  • All preterm (28 to 34 week gestation) very low birth weight (birth weight 750-1500grams.) infants born at AIIMS would be eligible for enrollment in the study. Of these infants, those who meet the following criteria would be enrolled.
  • Cases: Preterm (28 to 34 week gestation) infants with birth weight between 750 and 1500 grams with shock in the first week of life requiring vasopressor therapy (dopamine or dobutamine or both in a dose of > 10 mcg/kg/min)
  • Controls: Stable preterm (28 to 34 week gestation) infants with birth weight between 750 and 1500 grams who are matched for gestational age, birth weight, postnatal-age.

Exclusion Criteria:

  • Major congenital malformations
  • Mother receiving anticonvulsant / anti-tubercular drugs (rifampicin, isoniazid)
  • Postnatal corticosteroid treatment
  • Refusal to give consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Shock

Preterm VLBW infants with shock (BP <3rd centile for gestation and birth weight with at least one of the following:

  1. Prolonged capillary refill time (>3sec)
  2. Reduced urine output (<1 mL/kg/hr)
  3. Metabolic acidosis (Base deficit >5)
No shock
Hemodynamically stable infant with normal blood pressure, capillary refill time, and urine output

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Baseline cortisol
Time Frame: At enrollment
At enrollment
Stimulated cortisol (after ACTH stimulation)
Time Frame: 30 minutes after ACTH stimulation
30 minutes after ACTH stimulation

Secondary Outcome Measures

Outcome Measure
Time Frame
Survival till discharge or day 28 of life
Time Frame: Until discharge or 28 days of life
Until discharge or 28 days of life
Chronic lung disease (CLD)
Time Frame: 36 weeks postmenstrual age
36 weeks postmenstrual age
Sepsis
Time Frame: until 28 days of life
until 28 days of life

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Chair: Vinod K Paul, MD PhD, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi
  • Principal Investigator: Suman Sarkar, MBBS, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi
  • Study Chair: Mari J Sankar, MD DM, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi
  • Study Chair: Ramesh Agarwal, MD DM, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

March 1, 2008

Primary Completion (Actual)

November 1, 2009

Study Completion (Actual)

November 1, 2009

Study Registration Dates

First Submitted

September 9, 2009

First Submitted That Met QC Criteria

September 9, 2009

First Posted (Estimate)

September 10, 2009

Study Record Updates

Last Update Posted (Estimate)

January 14, 2015

Last Update Submitted That Met QC Criteria

January 13, 2015

Last Verified

January 1, 2015

More Information

Terms related to this study

Other Study ID Numbers

  • A-123/2008

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Adrenal Insufficiency

Search Similar Trials