Introduction: Preterm infants are liable to various health problems including\nrespiratory distress syndrome (RDS). There is variation in response to respiratory\nsupport. In preterm infants, cortisol hormone is secreted by the adrenocortical\ngland in response to stress. Objectives: To compare the serum\ncortisol levels in blood among preterm infants who needed different respiratory\nsupport strategies e.g. headbox, continuous positive airway pressure\n(CPAP), intubation surfactant extubation (INSURE) and mechanical ventilation\n(MV) and to correlate the cortisol levels to the severity of respiratory\ndistress syndrome (RDS). Material and Methods: Observational prospective\nstudy that assessed the serum cortisol levels in preterm infants with RDS after\ninitial respiratory support aged 28 - 34 gestational weeks that were admitted\nto the neonatal intensive care unit of Al Zahraa hospital of Al-Azhar University\nand Al-Estekama hospital between February 2019 and November 2019.\nInfants were classified into three groups, Group 1: 29 infants with severe RDS\nwho needed a mechanical ventilator. Ten of them needed surfactant therapy.\nGroup 2: 33 infants with moderate RDS who needed CPAP. Three of them\nneeded surfactant therapy. Group 3: 28 infants with symptoms of mild RDS\nwho needed headbox. None of them needed surfactant therapy. Blood samples\nwere collected on the first day of life and were processed using the colorimetric\nELISA method. Demographic and medical information was collected.\nResults: A total of 90 preterm infants were included.......................
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