Endocrine Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference.

Autor:	Srinivasan V; Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Lee JH; Children's Intensive Care Unit, KK Women's and Children's Hospital and Duke-National University of Singapore Medical School, Singapore., Menon K; Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario, Canada., Zimmerman JJ; Pediatric Critical Care Medicine, Seattle Children's Hospital, Harborview Medical Center and School of Medicine, University of Washington, Seattle, Washington., Bembea MM; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland., Agus MSD; Division of Medical Critical Care, Boston Children's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2022 Jan 01; Vol. 149 (1 Suppl 1), pp. S84-S90.
DOI:	10.1542/peds.2021-052888M
Abstrakt:	Context: Endocrine dysfunction is common in critically ill children and is manifested by abnormalities in glucose, thyroid hormone, and cortisol metabolism. Objective: To develop consensus criteria for endocrine dysfunction in critically ill children by assessing the association of various biomarkers with clinical and functional outcomes. Data Sources: PubMed and Embase were searched from January 1992 to January 2020. Study Selection: We included studies in which researchers evaluated critically ill children with abnormalities in glucose homeostasis, thyroid function and adrenal function, performance characteristics of assessment and/or scoring tools to screen for endocrine dysfunction, and outcomes related to mortality, organ-specific status, and patient-centered outcomes. Studies of adults, premature infants or animals, reviews and/or commentaries, case series with sample size ≤10, and non-English-language studies were excluded. Data Extraction: Data extraction and risk-of-bias assessment for each eligible study were performed by 2 independent reviewers. Results: The systematic review supports the following criteria for abnormal glucose homeostasis (blood glucose [BG] concentrations >150 mg/dL [>8.3 mmol/L] and BG concentrations <50 mg/dL [<2.8 mmol/L]), abnormal thyroid function (serum total thyroxine [T4] <4.2 μg/dL [<54 nmol/L]), and abnormal adrenal function (peak serum cortisol concentration <18 μg/dL [500 nmol/L]) and/or an increment in serum cortisol concentration of <9 μg/dL (250 nmol/L) after adrenocorticotropic hormone stimulation. Limitations: These included variable sampling for BG measurements, limited reporting of free T4 levels, and inconsistent interpretation of adrenal axis testing. Conclusions: We present consensus criteria for endocrine dysfunction in critically ill children that include specific measures of BG, T4, and adrenal axis testing. Competing Interests: FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. (Copyright © 2022 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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