Impact of IV-line Insertion on Salivary Cortisol Levels as a Stress Biomarker in Children

Abstract

BACKGROUND: Children with leukemia will be treated for a quite long period of time that they will be subjected to multiple invasive procedures, one of which is IV-line insertion. This procedure can cause stress, which increases cortisol levels in the body. AIM: This study aimed to investigate how IV-line insertion affected cortisol levels as a stress biomarker in children. METHODS: This is a single-group pre-test and post-test design pre-experimental study. The study enrolled 30 children undergoing IV line insertion, aged from 6 to 18 years, who had not been eating or drinking for 30 min before the saliva sampling was scheduled to get IV-line insertion. The ELISA test was used to measure the salivary cortisol. If the difference in the cortisol levels is > 0.05 ng/ml, it is clinically significant. Furthermore, the Wilcoxon test was used to analyze the data. Cortisol changes were considered statistically significant if the p-value was <0.05. RESULTS: The cortisol levels were 3.43 (0.19–16.67) ng/ml and 4.14 (0.19–16.67) ng/ml before and after IV-Line insertion, respectively. The difference in the median was 0.71 ng/ml. The > 0.05 ng/ml difference indicates that IV-line insertion affects cortisol elevation. The Wilcoxon test showed a value of p = 0.34 (p > 0.05) indicating that IV-line insertion had no statistically significant effect on cortisol. CONCLUSION: Although an IV-line insertion does not have a statistically significant effect on cortisol, it clinically influences the increase of cortisol in children with leukemia.