Peacock - A Paediatric Cortisol Study
Research type
Research Study
Full title
Hypothalamic-pituitary-adrenal (HPA) axis: function and control mechanisms in children undergoing cardiac surgery
IRAS ID
192117
Contact name
Gianni Angelini
Contact email
Sponsor organisation
University Hospital Bristol
Duration of Study in the UK
4 years, 0 months, 0 days
Research summary
We aim to study the stress response to cardiac surgery and cardiac catheterisation in children and babies. Cardiac surgery triggers a major inflammatory response. The ‘inflammatory response’ is a set of reactions which when localised (such as a twisted ankle) can promote rapid healing of the injured part. When the injury is larger however (such as major surgery, burns or infection), this set of reactions can affect all tissues of the body leading to generalised inflammation with subsequent multiple organ dysfunction and in some cases death. One of the hormones that protects against an uncontrolled inflammatory response is the steroid hormone cortisol. Some units give synthetic cortisol type drugs routinely to children having cardiac surgery in an attempt to reduce this inflammatory response. However, it is currently unclear if this is associated with better outcomes. Humans produce their own cortisol in a diurnal rhythm (it is high when you first wake in the morning and lowest in the late evening).This rhythm actually consists approximately hourly pulses of cortisol (an ultradian rhythm). No-one has ever investigated the changes in ultradian regulation of cortisol secretion in the perioperative period in neonates, infants and children. There is good reason to believe that both the size and frequency of these pulses is important for good homeostatic regulation by cortisol. It has been shown by our group that these pulses change dramatically after adult heart surgery. The current study is designed to see what happens to these pulses when children and babies undergo cardiac surgery. We will compare this surgical cohort with a group of children undergoing cardiac investigation. Once we know what is ‘normal’ we will then be in a position to make rational decisions about when and if extra steroid therapy is needed in paediatric cardiac surgery
REC name
South West - Central Bristol Research Ethics Committee
REC reference
16/SW/0186
Date of REC Opinion
20 Sep 2016
REC opinion
Further Information Favourable Opinion