807 Hypocortisolemia in Sick Children on Paediatric Intensive Care Unit (PICU): Transient or Cause for Concern

Background and Aims Cortisol insufficiency has been reported in sick children with severe sepsis, post-cardiac surgery, and may contribute to rapid cardiovascular collapse. Hypothalamic-pituitary-adrenal axis dysfunction may play a role in low-cardiac-output syndrome. We performed a review of PICU patients to describe cortisol levels in those with suspected adrenal insufficiency. Methods Retrospective review of PICU patients (general and cardiac cases) over 6 months from April to September 2011, who had cortisol levels checked and/or received hydrocortisone. Results Total PICU admissions were 519, of which 30(5.7%) patients had cortisol levels. Most common indication for cortisol assessment was refractory hypotension (73%) in cardiac and sepsis patients. 12/30(40%) had cortisol levels Conclusions Our data shows that hypocortisolemia can be transient in sick PICU patients, and may play a role in low-cardiac-output syndrome. There is a need to identify these complex patients with high mortality, and have a uniform management policy jointly with advice and follow-up by the Endocrine team.