PLASMA CORTICOSTEROIDS IN INFANTS WITH THE RESPIRATORY DISTRESS SYNDROME

Plasma total corticosteroid concentrations were measured in 44 premature infants with the respiratory distress syndrome (RDS). Further assay of serum concentrations of cortisol, cortisone, corticosterone, corticosterone sulfate, and 11-deoxycorticosterone sufate was carried out in 24 of these infants and in 10 healthy, nonstressed premature controls. Infants with RDS had higher concentrations of cortisol (22.1±4.3µg/100 ml) and corticosterone sulfate (7.7 ± 0.8 µg/100 ml) than control infants (6.6 ± 0.8 µg/100 ml, 1.2 ± 0.3 µg/100 ml, and 4.2 ± 0.4 µg/100 ml, respectively). A significant correlation was found with the five-minute Apgar score (negative correlation, p = 0.005) and a possible correlation with the A-aDO2 gradient. Among premature infants with RDS, those of 32 weeks9 gestation or less had higher concentrations of cortisol (28.3 ± 23.6 µg/100 ml) and corticosterone (3.9 ± 2.7 µg/100 ml) than those of more than 32 weeks (11.5 ± 5.4 µg/100 ml and 1.7 ± 0.7 µg/100 ml, respectively), suggesting either elevated response to stress or a diminished ability to metabolize these compounds.