Corticosteroids for Neonatal Hypotension

Neha Kumbhat; Shahab Noori

doi:10.1016/j.clp.2020.05.015

Corticosteroids for Neonatal Hypotension

Clin Perinatol. 2020 Sep;47(3):549-562. doi: 10.1016/j.clp.2020.05.015. Epub 2020 May 22.

Authors

Neha Kumbhat¹, Shahab Noori²

Affiliations

¹ Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
² Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. Electronic address: snoori@chla.usc.edu.

PMID: 32713450
DOI: 10.1016/j.clp.2020.05.015

Abstract

Several limitations and controversies surround the definition of hypotension; however, it remains one of the most common problems faced by neonates. Approximately 15% to 30% of neonates with hypotension fail to respond to volume and/or vasopressor or inotropes. They are considered to have refractory hypotension. Although it is thought to have multiple causes, absolute and relative adrenal insufficiency is considered as the main reason for refractory hypotension. This article focuses on the role of adrenal insufficiency in causing refractory hypotension in preterm and term infants, the different options of corticosteroids available, and their risk/benefit profiles.

Keywords: Adrenal insufficiency; Dexamethasone; Hydrocortisone.

Publication types

Review

MeSH terms

Adrenal Cortex Hormones / therapeutic use*
Adrenal Insufficiency / drug therapy*
Adrenal Insufficiency / physiopathology
Humans
Hydrocortisone / therapeutic use*
Hypotension / drug therapy*
Hypotension / physiopathology
Infant, Newborn
Infant, Premature

Substances

Adrenal Cortex Hormones
Hydrocortisone