Refractory hypotension in preterm infants with adrenocortical insufficiency
P C Nga, C W K Lamb, T F Foka, C H Leea, K C Maa, I H S Chanb, E Wongc
a Department
of Paediatrics, Prince of Wales Hospital, The Chinese University of
Hong Kong, b Department of Chemical Pathology, c Centre for Clinical
Trials and Epidemiological Research
Correspondence to: Professor Ng, Department of Paediatrics, Level 6, Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kong pakcheungng{at}cuhk.edu.hk
Accepted 6 October
2000
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.
Keywords: adrenal insufficiency; corticosteroid; human corticotrophin releasing hormone (hCRH); hypotension; inotrope treatment; preterm
© 2001 by Archives of Disease in Childhood
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