Abstract
OBJECTIVE:
To determine the prevalence of low cortisol values and to evaluate clinical responses to hydrocortisone in ill term and near-term newborns.
STUDY DESIGN:
Retrospective cohort study including infants ≥35 weeks gestational age who were mechanically ventilated, received vasopressor therapy, and had a cortisol concentration obtained for evaluation of vasopressor-resistant hypotension. In those infants treated with hydrocortisone, physiologic responses were evaluated and correlated with cortisol values (<15 vs ≥15 μg/dl).
RESULTS:
A total of 32 infants had cortisol values obtained; 18 (56%) were <15 μg/dl. In all, 21 infants were treated with hydrocortisone of whom 13 had cortisol values <15 μg/dl. These 13 infants showed decreased heart rate, dopamine support and fluid bolus requirements after treatment, compared to infants with values ≥15 μg/dl (n=8).
CONCLUSIONS:
A significant number of hypotensive, mechanically ventilated infants have evidence of inadequate adrenal function. Hydrocortisone therapy resulted in hemodynamic stabilization in this population.
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Fernandez, E., Schrader, R. & Watterberg, K. Prevalence of Low Cortisol Values in Term and Near-Term Infants with Vasopressor-Resistant Hypotension. J Perinatol 25, 114–118 (2005). https://doi.org/10.1038/sj.jp.7211211
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DOI: https://doi.org/10.1038/sj.jp.7211211
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