Abstract
Cortisol release in the face of illness or stress is vital for survival. Relative adrenal insufficiency occurs when a patient's cortisol response is inadequate for the degree of illness or stress. Numerous studies have documented the existence of relative adrenal insufficiency in critically ill adults, and its association with increased morbidity and mortality. There is increasing evidence that relative adrenal insufficiency may be an etiology for hemodynamic instability and hypotension in the critically ill newborn, but compared with the adult population, there is still a paucity of data in this population. Randomized controlled trials are needed to evaluate the efficacy and safety of glucocorticoids for the treatment of cardiovascular insufficiency due to relative adrenal insufficiency in ill preterm and term newborn infants.
MeSH terms
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Adrenal Insufficiency / blood
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Adrenal Insufficiency / complications
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Adrenal Insufficiency / congenital*
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Adrenal Insufficiency / diagnosis
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Adrenal Insufficiency / drug therapy
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Adrenocorticotropic Hormone / blood
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Adrenocorticotropic Hormone / therapeutic use
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Anti-Inflammatory Agents / adverse effects
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Anti-Inflammatory Agents / therapeutic use
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Blood Pressure / drug effects
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Blood Pressure / physiology
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Dose-Response Relationship, Drug
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Gestational Age
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Hemodynamics / drug effects
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Hemodynamics / physiology
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Humans
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Hydrocortisone / adverse effects
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Hydrocortisone / blood
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Hydrocortisone / therapeutic use
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Hypothalamo-Hypophyseal System / drug effects
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Hypothalamo-Hypophyseal System / physiopathology
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Infant, Extremely Low Birth Weight
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Infant, Newborn
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Infant, Premature, Diseases / blood
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Infant, Premature, Diseases / diagnosis*
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Infant, Premature, Diseases / drug therapy
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Intensive Care, Neonatal
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Pituitary-Adrenal System / drug effects
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Pituitary-Adrenal System / physiopathology
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Respiration, Artificial
Substances
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Anti-Inflammatory Agents
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Adrenocorticotropic Hormone
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Hydrocortisone