الفهرس 
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Abstract
BACK GROUND:
Neonatal sepsis is a clinical and laboratory syndrome resulting from the hemodynamic and metabolic consequences of bacterial invasion of the blood and or other body systems in the first month of life. Severe illness or stress including infections activate the hypothalamic-pituitary adrenal axis and stimulate the release of corticotrophin (ACTH) from the pituitary, which in turn increases the release of cortisol from the adrenal cortex. This activation is an essential component of the general adaptation to illness and stress, and contributes to the maintenance of cellular and organ homeostasis. Neonates are unable to respond effectively to infectious hazards because of deficits in their immune system and all the essential functions of host defense cells are depressed further when an infant is stressed by infection. For the neonate to cope with such situation, an appropriate stress response should go into action. This response involves recrument of all body systems especially nervous, endocrine and immune systems.
OBJECTIVES:
Study of some aspects of adrenal function in newborn infants suffering from bacterial sepsis
METHODS:
The present study aimed at evaluating some aspects of adrenal function in newborn infants suffering from bacterial sepsis. The study included fifty septic newborns divided into two groups according to their gestational age (GA). Group 1 (GA 33- 37 weeks), Group II (GA 37- 40 weeks). In addition, 30 normal infants (GA 35- 41 weeks) born to healthy mothers by spontaneous vaginal delivery were included as controls (Group III). Venous samples were obtained from the studied infants for measurement of basal cortisol, ACTH, 17-OH progesterone and aldosterone. Synthetic ACTH (synecthen 1-24) were injected intramuscularly after taking the samples followed by a second venous sample 60 minutes later to assess cortisol value after stimulation. In addition, urine vanillyl mandelic acid was measured in a 24-hour urine collection to evaluate medullary function.
RESULTS:
The response of the studied septic neonates to exogenous ACTH stimulation was efficient with at least 2 folds increment in their serum cortisol levels that means the presence of sufficient reserve. ACTH stimulation raised serum cortisol from values ranging from 5 to 15 ug/dl to values more than 18 ug/dl that was considered to be the minimum necessary to ensure adequate adrenal reserve in adults, children and neonates. (228, 229, 236, 231)