Evidence map›Paper›PMID 30867544›Full record

Observational studyJournal of perinatology : official journal of the California Perinatal Association2019

Adrenal insufficiency in neonates undergoing cardiopulmonary bypass and postoperative hypothalamic-pituitary-adrenal function after prophylactic glucocorticoids.

Anson Tang, Charles R Rosenfeld, Michel Mikhael, Michael J McPhaul, Joshua D Koch

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of perinatology : official journal of the California Perinatal Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 8 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Anson TangDivision of Neonatal-Perinatal, Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, TX, USA.
Charles R RosenfeldDivision of Neonatal-Perinatal, Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, TX, USA. charles.rosenfeld@utsouthwestern.edu.ORCID http://orcid.org/0000-0002-9208-6539
Michel MikhaelDivision of Neonatal-Perinatal, Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, TX, USA.
Michael J McPhaulDepartment of Internal Medicine, University of Texas Southwestern Medical School, Dallax, TX, USA and Quest Diagnostics Nichols Institute, San Juan Capistrano, CA, USA.
Joshua D KochDivision of Critical Care Medicine, Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, TX, USA.
The University of Texas Southwestern Medical Center · USQuest Diagnostics (United States) · USSouthwestern Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDetermine incidence of preoperative adrenal insufficiency in neonates >35 weeks gestation with congenital heart disease undergoing cardiothoracic surgery with bypass and effects of prophylactic methylprednisolone on postoperative hypothalamic-pituitary-adrenal function and hemodynamic stability.

designProspective observational study in 36 neonates with preoperative adrenocorticotrophic hormone stimulation tests and serial total cortisol and adrenocorticotrophic hormone measurements before and after surgery. Data analyses: analysis of variance and regression.

resultsBaseline circulating adrenocorticotrophic hormone and cortisol were unchanged 4-20 days postnatal (P > 0.1); however, cortisol levels rose with increasing adrenocorticotrophic hormone, P = 0.02. Ten neonates (29%) demonstrated preoperative adrenal insufficiency (∆cortisol ≤9 µg/dl); one had postoperative hemodynamic instability. Growth-restricted neonates had lower baseline cortisol, but normal stimulation tests and responded well to surgical stresses. Seventy-five percent of neonates receiving perioperative methylprednisolone demonstrated postoperative hypothalamic-pituitary-adrenal inhibition.

conclusionAdrenal insufficiency appears common in neonates >35 weeks gestation with congenital heart disease, but did not contribute to postoperative hemodynamic instability despite hypothalamic-pituitary-adrenal inhibition.

Indexed as

Adrenal InsufficiencyAdrenocorticotropic HormoneCardiopulmonary BypassFemaleGlucocorticoidsHeart Defects, CongenitalHumansHydrocortisoneHypothalamo-Hypophyseal SystemInfant, NewbornLinear ModelsMalePituitary-Adrenal SystemProspective StudiesAdrenocorticotropic HormoneGlucocorticoidsHydrocortisone

Identifiers

PMID30867544
OpenAlexW2922048642

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.