Journal
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
Volume 84, Issue 2, Pages F122-F124Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/fn.84.2.F122
Keywords
adrenal insufficiency; corticosteroid; human corticotrophin releasing hormone (hCRH); hypotension; inotrope treatment; preterm
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Five preterm, very low birthweight infants with severe hypotension and adrenocortical insufficiency are described. The profound hypotension was resistant to volume expansion and inotrope treatment, but responded promptly to corticosteroid treatment. A human corticotrophin releasing hormone (hCRH) test performed before corticosteroid treatment showed adequate pituitary response, and the endocrine dysfunction was identified at the adrenal level. Corticosteroid treatment should be considered and could be life saving in severely hypotensive preterm infants who do not respond to conventional treatment with volume expanders and inotropes.
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