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J Perinatol. 2005 Feb;25(2):114-8.

Prevalence of low cortisol values in term and near-term infants with vasopressor-resistant hypotension.

Author information

1
Department of Pediatrics/Neonatology (E.F., K.W.), The University of New Mexico Health Sciences Center, Albuquerque, NM 87131-0001, USA.

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 >or=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 >or=15 microg/dl).

RESULTS:

A total of 32 infants had cortisol values obtained; 18 (56%) were <15 microg/dl. In all, 21 infants were treated with hydrocortisone of whom 13 had cortisol values <15 microg/dl. These 13 infants showed decreased heart rate, dopamine support and fluid bolus requirements after treatment, compared to infants with values >or=15 microg/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.

PMID:
15526013
DOI:
10.1038/sj.jp.7211211
[Indexed for MEDLINE]

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