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Rapid increase of blood pressure in extremely low birth weight infants after a single dose of dexamethasone

  • Neonatology
  • Published:
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Abstract

Blood pressure was retrospectively studied in all 22 extremely low birth weight infants (ELBW) (birth weight median 720 g, range 450–1020 g) who were admitted between July 1989 and October 1991 and received dexamethasone on days 2–25 (median 10) because of bronchopulmonary dysplasia or since lung function had not improved after installation of bovine surfactant. The average blood pressure during the 4 h before dexamethasone increased significantly (median individual increase 8 mmHg,P=0.0005) until 8–12 h thereafter. In addition to the lung disease, ten infants showed severe arterial hypotension with prolonged capillary refilling time (>3s) and oliguria and needed continuous infusion of epinephrine to increase blood pressure and urinary flow after treatment with colloids, dopamine and dobutamine had proved ineffective. Epinephrine infusion could be stopped in eight infants 8h after dexamethasone administration. In ELBW infants blood pressure rose 8–12 h after a single dose of 0.25 mg/kg dexamethasone. In ELBW infants suffering from arterial hypotension who do not respond to infusion of colloids and catecholamines, dexamethasone may represent a new therapeutic tool.

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Abbreviations

ELBW:

extremely low birth weight

References

  1. Avery GB, Fletcher AB, Kaplan M, Brudno DS (1985) Controlled trial of dexamethasone in respirator-dependent infants with bronchopulmonary dysplasia. Pediatrics 75:106–111

    Google Scholar 

  2. Benini F, Rubaltelli P, Griffith P, Sala M, Zorzi C (1989) Dexamethasone in the treatment of bronchopulmonary dysplasia. Acta Paediatr Scand S 360:108–112

    Google Scholar 

  3. Brodde OE, Brinkmann M, Schemuth R, O'Hara N, Daul A (1985) Terbutaline-induced desensitization of human beta-2-adrenoceptors. J Clin Invest 76:1096–1101

    Google Scholar 

  4. Cotecchia S De, Blasi A (1984) Glucocorticoids increase beta-adrenoceptors on human intact lymphocytes in vitro. Life Sci 35:2359–2364

    Google Scholar 

  5. Collaborative Dexamethasone Trial Group (1991) Dexamethasone therapy in neonatal chronic lung disease: an international placebo-controlled trial. Pediatrics 88:421–427

    Google Scholar 

  6. Cummings JJ, D'Eugenio DB, Gross SJ (1989) A controlled trial of dexamethasone in preterm infants at high risk for bronchopulmonary dysplasia. N Engl J Med 320:1505–1510

    Google Scholar 

  7. Davies AO, Lefkowitz RJ (1980) Agonist promoted high affinity state of the beta-adrenergic receptor in human neutrophils: modulation by corticosteroids. J Clin Endocrinol Metab 53: 703–738

    Google Scholar 

  8. Davies AO, Lefkowitz RJ (1984) Regulation of beta-adrenergic receptors by steroid hormones. Ann Rev Physiol 46:119–130

    Google Scholar 

  9. Greenough A, Emery EF, Gamsu HR (1992) Dexamethasone and hypertension in preterm infants. Eur J Pediatr 151:134–135

    Google Scholar 

  10. Hadcock JR, Wang H, Malbon CC (1989) Agonist-induced destabilisation of beta-adrenergic receptor mRNA. J Biol Chem 264:19928–19933

    Google Scholar 

  11. Harkavy KL, Scanlon JW, Chowdhry PK, Grylack LJ (1989) Dexamethasone therapy for chronic lung disease in ventilator-and oxygen-dependent infants: a controlled trial. J Pediatr 115:979–983

    Google Scholar 

  12. Hui KK, Conolly ME, Tashkin DP (1982) Reversal of human lymphocyte beta-adrenoceptor desensitization by glucocorticoids. Clin Pharmacol Ther 32:566–571

    Google Scholar 

  13. Jazayeri A, Meyer WJ (1988) Glucocorticoid modulation of beta-adrenergic receptors of cultured rat arterial smooth muscle cells. Hypertension 12:393–398

    Google Scholar 

  14. Mano K, Akbarzadeh A, Townley RG (1979) Effect of hydrocortisone on beta-adrenergic receptors in lung membranes. Life Sci 25:1925–1930

    Google Scholar 

  15. Merz U, Kuehl G, Linderkamp O (1989) Dexamethason-Therapie bei bronchopulmonaler Dysplasie. Klin Pädiatr 201:11–15

    Google Scholar 

  16. Stone EA, Egawa M, Colbjorsen M (1989) Catecholamine-induced desensitization of brain betaadrenoceptors in vivo and reversal by corticosterone Life Sci 44:209–213

    Google Scholar 

  17. Yeh TF, Torre JA, Rastogi A, Anyebuno MA, Pildes RS (1990) Early postnatal dexamethasone therapy in premature infants with severe respiratory distress syndrome: a double-blind controlled study. J Pediatr 117:273–282

    Google Scholar 

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Authors and Affiliations

  1. Division of Neonatology and Paediatric Critical Care Medicine, Department of Paediatrics, University of Ulm, Prittwitzstrasse 43, W-7900, Ulm, Germany

    A. Fauser, F. Pohlandt, P. Bartmann & L. Gortner

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  1. A. Fauser
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  2. F. Pohlandt
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  3. P. Bartmann
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  4. L. Gortner
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Fauser, A., Pohlandt, F., Bartmann, P. et al. Rapid increase of blood pressure in extremely low birth weight infants after a single dose of dexamethasone. Eur J Pediatr 152, 354–356 (1993). https://doi.org/10.1007/BF01956753

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  • DOI: https://doi.org/10.1007/BF01956753

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