Relative adrenal insufficiency in the preterm and term infant.
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.
Fernandez
E F
EF
Division of Neonatology, Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM 87131-0001, USA. efernandez@salud.unm.edu
Watterberg
K L
KL
D000309:Adrenal Insufficiency / Q000097:blood / Q000150:complications / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D005865:Gestational Age; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000503:physiopathology; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D015931:Intensive Care, Neonatal; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000503:physiopathology; D012121:Respiration, Artificial
D000893:Anti-Inflammatory Agents; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone