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Arch Dis Child Fetal Neonatal Ed 84:F122-F124 doi:10.1136/fn.84.2.F122
  • Original article

Refractory hypotension in preterm infants with adrenocortical insufficiency

  1. P C Nga,
  2. C W K Lamb,
  3. T F Foka,
  4. C H Leea,
  5. K C Maa,
  6. I H S Chanb,
  7. E Wongc
  1. aDepartment of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, bDepartment of Chemical Pathology, cCentre for Clinical Trials and Epidemiological Research
  1. Professor Ng, Department of Paediatrics, Level 6, Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kongpakcheungng{at}cuhk.edu.hk
  • Accepted 6 October 2000

Abstract

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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