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Arch Dis Child Fetal Neonatal Ed 2001;84:F122-F124 ( March )

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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