Background: Intravenous hydrocortisone (HC) is often used in very low birth weight infants (VLBW) but can be complicated by oliguria when discontinued or tapered.
Objectives: To determine which factors were associated with oliguria during HC taper.
Methods: We reviewed all VLBW infants who received initial doses of HC ≥ 1 mg/kg/d. The initial dose and duration of HC, and the incidence of oliguria (urine output [UO] < 2 mL/kg/h) during HC taper, were recorded. In those with oliguria, we recorded the change in UO (mL/kg/h), blood pressure, and creatinine.
Results: The mean initial HC dose was 2.8 ± 1 mg/kg/d, and the mean total duration of HC therapy was 23 ± 25 days. Oliguria occurred in 24% (13/54) of treated infants. These infants were exposed to higher and longer duration of the initial HC dose than infants without oliguria. Oliguria was predicted by the initial HC dose (odds ratio [OR] 5.8, 95% confidence interval [CI] 1.3-25.8, p = 0.02) and by the number of days at initial dose (OR 1.7, 95%CI 1.1-2.7, p = 0.03).
Conclusions: Oliguria during HC dosage weaning was associated with higher initial HC exposure.
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