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Review Article| Volume 47, ISSUE 3, P549-562, September 2020

Corticosteroids for Neonatal Hypotension

  • Neha Kumbhat
    Affiliations
    Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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  • Shahab Noori
    Correspondence
    Corresponding author. Division of Neonatology, Fetal and Neonatal Institute, Children’s Hospital Los Angeles, 4650 Sunset Boulevard, MS # 31, Los Angeles, CA 90027.
    Affiliations
    Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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      Reference

        • Noori S.
        • Seri I.
        Evidence-based versus pathophysiology-based approach to diagnosis and treatment of neonatal cardiovascular compromise.
        Semin Fetal Neonatal Med. 2015; 20: 238-245
        • Hegyi T.
        • Carbone M.T.
        • Anwar M.
        • et al.
        Blood pressure ranges in premature infants. I. The first hours of life.
        J Pediatr. 1994; 124: 627-633
        • Lee J.
        • Rajadurai V.S.
        • Tan K.W.
        Blood pressure standards for very low birthweight infants during the first day of life.
        Arch Dis Child Fetal Neonatal Ed. 1999; 81: F168-F170
        • Versmold H.T.
        • Kitterman J.A.
        • Phibbs R.H.
        • et al.
        Aortic blood pressure during the first 12 hours of life in infants with birth weight 610 to 4,220 grams.
        Pediatrics. 1981; 67: 607-613
        • Watkins A.M.C.
        • West C.R.
        • Cooke R.W.I.
        Blood pressure and cerebral haemorrhage and ischaemia in very low birthweight infants.
        Early Hum Dev. 1989; 19: 103-110
        • Al-Aweel I.
        • Pursley D.M.
        • Rubin L.P.
        • et al.
        Variations in prevalence of hypotension, hypertension, and vasopressor use in NICUs.
        J Perinatol. 2001; 21: 272-278
        • Dempsey E.M.
        • Barrington K.J.
        Diagnostic criteria and therapeutic interventions for the hypotensive very low birth weight infant.
        J Perinatol. 2006; 26: 677-681
        • Sehgal A.
        • Osborn D.
        • McNamara P.J.
        Cardiovascular support in preterm infants: a survey of practices in Australia and New Zealand: survey of practice of inotropic support.
        J Paediatr Child Health. 2012; 48: 317-323
        • Faust K.
        • Härtel C.
        • Preuß M.
        • et al.
        Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life.
        Arch Dis Child Fetal Neonatal Ed. 2015; 100: F388-F392
        • Stranak Z.
        • Semberova J.
        • Barrington K.
        • et al.
        • On behalf of the HIP consortium
        International survey on diagnosis and management of hypotension in extremely preterm babies.
        Eur J Pediatr. 2014; 173: 793-798
        • Fernandez E.
        • Watterberg K.
        • Faix R.
        • et al.
        Incidence, management, and outcomes of cardiovascular insufficiency in critically ill term and late preterm newborn infants.
        Am J Perinatol. 2014; 31: 947-956
        • Rios D.R.
        • Moffett B.S.
        • Kaiser J.R.
        Trends in Pharmacotherapy for neonatal hypotension.
        J Pediatr. 2014; 165: 697-701.e1
        • Verma R.P.
        • Dasnadi S.
        • Zhao Y.
        • et al.
        A comparative analysis of ante- and postnatal clinical characteristics of extremely premature neonates suffering from refractory and non-refractory hypotension: is early clinical differentiation possible?.
        Early Hum Dev. 2017; 113: 49-54
        • Bourchier D.
        • Weston P.J.
        Randomised trial of dopamine compared with hydrocortisone for the treatment of hypotensive very low birthweight infants.
        Arch Dis Child Fetal Neonatal Ed. 1997; 76: F174-F178
        • Ibrahim H.
        • Sinha I.P.
        • Subhedar N.V.
        Corticosteroids for treating hypotension in preterm infants. Cochrane Neonatal Group.
        Cochrane Database Syst Rev. 2011; https://doi.org/10.1002/14651858.CD003662.pub4
        • Noori S.
        • McNamara P.
        • Jain A.
        • et al.
        PDA Ligation/Hypotension Trial Investigators. Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation.
        J Perinatol. 2015; 35: 123-127
        • Seri I.
        Hydrocortisone and vasopressor-resistant shock in preterm neonates.
        Pediatrics. 2006; 117: 516-518
        • Ogasawara K.
        • Sato M.
        • Hashimoto K.
        • et al.
        A polymorphism in the glucocorticoid receptor gene is associated with refractory hypotension in premature infants.
        Pediatr Neonatol. 2018; 59: 251-257
        • Hausdorff W.P.
        • Caron M.G.
        • Lefkowitz R.J.
        Turning off the signal: desensitization of beta-adrenergic receptor function.
        FASEB J. 1990; 4: 2881-2889
        • Watterberg K.
        Fetal adrenal development: implications for lung development and postnatal disease.
        NeoReviews. 2006; 7: e135-e142
        • Ishimoto H.
        • Jaffe R.B.
        Development and function of the human fetal adrenal cortex: a key component in the feto-placental unit.
        Endocr Rev. 2011; 32: 317-355
        • Mesiano S.
        • Jaffe R.B.
        • Mesiano S.
        Developmental and functional biology of the primate fetal adrenal cortex.
        Endocr Rev. 1997; 18: 378-403
        • Pepe G.J.
        • Albrecht E.D.
        Actions of placental and fetal adrenal steroid hormones in primate pregnancy.
        Endocr Rev. 1995; 16: 41
        • McLean M.
        • Smith R.
        • McLean M.
        • et al.
        Corticotrophin-releasing hormone and human parturition.
        Reproduction. 2001; 121: 493-501
        • Naito Y.
        • Fukata J.
        • Tamai S.
        • et al.
        Biphasic Changes in Hypothalamo-Pituitary-Adrenal function during the early recovery period after major abdominal surgery.
        J Clin Endocrinol Metab. 1991; 73: 111-117
        • Anand K.J.
        • Hansen D.D.
        • Hickey P.R.
        Hormonal-metabolic stress responses in neonates undergoing cardiac surgery.
        Anesthesiology. 1990; 73: 661-670
        • Pittinger T.P.
        • Sawin R.S.
        Adrenocortical insufficiency in infants with congenital diaphragmatic hernia: a pilot study.
        J Pediatr Surg. 2000; 35: 223-226
        • Khashana A.
        • Saarela T.
        • Ramet M.
        • et al.
        Cortisol intermediates and hydrocortisone responsiveness in critical neonatal disease.
        J Matern Fetal Neonatal Med. 2017; 30: 1721-1725
        • Fernandez E.
        • Schrader R.
        • Watterberg K.
        Prevalence of low cortisol values in term and near-term infants with vasopressor-resistant hypotension.
        J Perinatol. 2005; 25: 114-118
        • Fernandez E.F.
        • Montman R.
        • Watterberg K.L.
        ACTH and cortisol response to critical illness in term and late preterm newborns.
        J Perinatol. 2008; 28: 797-802
        • Cooper M.S.
        • Stewart P.M.
        Corticosteroid insufficiency in acutely ill patients.
        N Engl J Med. 2003; 348: 727-734
        • Watterberg K.L.
        • Scott S.M.
        Evidence of early adrenal insufficiency in babies who develop bronchopulmonary dysplasia.
        Pediatrics. 1995; 95: 120-125
        • Ng P.C.
        • Lam C.W.K.
        • Lee C.H.
        • et al.
        Reference ranges and factors affecting the human corticotropin-releasing hormone test in preterm, very low birth weight infants.
        J Clin Endocrinol Metab. 2002; 87: 4621-4628
        • Kamath B.D.
        • Fashaw L.
        • Kinsella J.P.
        Adrenal insufficiency in newborns with congenital diaphragmatic hernia.
        J Pediatr. 2010; 156: 495-497.e1
        • Soliman A.T.
        • Taman K.H.
        • Rizk M.M.
        • et al.
        Circulating adrenocorticotropic hormone (ACTH) and cortisol concentrations in normal, appropriate-for-gestational-age newborns versus those with sepsis and respiratory distress: cortisol response to low-dose and standard-dose ACTH tests.
        Metabolism. 2004; 53: 209-214
        • Joosten K.F.M.
        • Kleijn E.D.D.
        • Westerterp M.
        • et al.
        Endocrine and metabolic responses in children with meningoccocal sepsis: striking differences between survivors and non-survivors.
        J Clin Endocrinol Metab. 2000; 85: 8
        • Iijima S.
        Late-onset glucocorticoid-responsive circulatory collapse in premature infants.
        Pediatr Neonatol. 2019; (S1875957219305017)https://doi.org/10.1016/j.pedneo.2019.09.005
        • Watterberg K.L.
        Adrenocortical function and dysfunction in the fetus and neonate.
        Semin Neonatol. 2004; 9: 13-21
        • Briegel J.
        • Jochum M.
        • Gippner-Steppert C.
        • et al.
        Immunomodulation in septic shock: hydrocortisone differentially regulates cytokine responses.
        J Am Soc Nephrol. 2001; 5: S70-S74
        • Ng P.C.
        Is There a “Normal” range of serum cortisol concentration for preterm infants?.
        Pediatrics. 2008; 122: 873-875
        • Aucott S.W.
        The challenge of defining relative adrenal insufficiency.
        J Perinatol. 2012; 32: 397-398
        • Dellinger R.P.
        • Levy M.M.
        • Rhodes A.
        • The Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup
        Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012.
        Intensive Care Med. 2013; 39: 165-228
        • Yehya N.
        • Vogiatzi M.G.
        • Thomas N.J.
        • et al.
        Cortisol correlates with severity of Illness and poorly reflects adrenal Function in pediatric acute respiratory distress Syndrome.
        J Pediatr. 2016; 177: 212-218.e1
        • Ng P.C.
        Transient adrenocortical insufficiency of prematurity and systemic hypotension in very low birthweight infants.
        Arch Dis Child Fetal Neonatal Ed. 2004; 89: 119F-126
        • Aucott S.W.
        • Watterberg K.L.
        • Shaffer M.L.
        • et al.
        • for the PROPHET Study Group
        Do cortisol concentrations predict short-term outcomes in extremely low birth weight infants?.
        Pediatrics. 2008; 122: 775-781
        • Buttgereit F.
        • Brand M.D.
        • Burmester G.-R.
        Equivalent doses and relative drug potencies for non-genomic glucocorticoid effects: a novel glucocorticoid hierarchy.
        Biochem Pharmacol. 1999; 58: 363-368
        • Tsao P.
        • von Zastrow M.
        Downregulation of G protein-coupled receptors.
        Curr Opin Neurobiol. 2000; 10: 365-369
        • Seri I.
        • Tan R.
        • Evans J.
        Cardiovascular effects of hydrocortisone in preterm infants with pressor-resistant hypotension.
        Pediatrics. 2001; 107: 1070-1074
        • Schneider A.J.
        Abrupt hemodynamic improvement in late septic shock with physiological doses of glucocorticoids.
        Intensive Care Med. 1991; 17: 436-437
        • Ng P.C.
        A double-blind, randomized, controlled study of a “stress dose” of hydrocortisone for rescue treatment of refractory hypotension in preterm infants.
        Pediatrics. 2006; 117: 367-375
        • Watterberg K.L.
        • Gerdes J.S.
        • Cole C.H.
        • et al.
        Prophylaxis of early adrenal insufficiency to prevent bronchopulmonary dysplasia: a multicenter trial.
        Pediatrics. 2004; 114: 1649-1657
        • Higgins S.
        • Friedlich P.
        • Seri I.
        Hydrocortisone for hypotension and vasopressor dependence in preterm neonates: a meta-analysis.
        J Perinatol. 2010; 30: 373-378
        • Noori S.
        • Friedlich P.
        • Wong P.
        • et al.
        Hemodynamic changes after low-dosage hydrocortisone administration in vasopressor-treated preterm and term neonates.
        Pediatrics. 2006; 118: 1456-1466
        • Noori S.
        • Siassi B.
        • Durand M.
        • et al.
        Cardiovascular effects of low-dose dexamethasone in very low birth weight neonates with refractory hypotension.
        Neonatology. 2006; 89: 82-87
        • Tantivit P.
        • Subramanian N.
        • Garg M.
        • et al.
        Low serum cortisol in term newborns with refractory hypotension.
        J Perinatol. 1999; 19: 352-357
        • Gaissmaier R.E.
        • Pohlandt F.
        Single-dose dexamethasone treatment of hypotension in preterm infants.
        J Pediatr. 1999; 134: 5
        • Kopelman A.E.
        • Moise A.A.
        • Holbert D.
        • et al.
        Respiratory and cardiovascular adaptation in preterm infants.
        J Pediatr. 1999; 135: 6
        • De Kloet R.E.
        • Vreugdenhil E.
        • Oitzl M.S.
        • et al.
        Brain corticosteroid receptor balance in health and disease.
        Endocr Rev. 1998; 19: 269-301
        • Hassan A.H.S.
        • von Rosenstiel P.
        • Patchev V.K.
        • et al.
        Exacerbation of apoptosis in the dentate gyrus of the aged rat by dexamethasone and the protective role of corticosterone.
        Exp Neurol. 1996; 140: 43-52
        • Crochemore C.
        • Lu J.
        • Wu Y.
        • et al.
        Direct targeting of hippocampal neurons for apoptosis by glucocorticoids is reversible by mineralocorticoid receptor activation.
        Mol Psychiatry. 2005; 10: 790-798
        • Murphy B.P.
        • Inder T.E.
        • Huppi P.S.
        • et al.
        Impaired cerebral cortical gray matter growth after treatment with dexamethasone for neonatal chronic lung disease.
        Pediatrics. 2001; 107: 217-221
        • Mammel M.C.
        • Johnson D.E.
        • Green T.P.
        • et al.
        Controlled trial of dexamethasone therapy in infants with bronchopulmonary dysplasia.
        Lancet. 1983; 321: 1356-1358
        • Yeh T.F.
        • Torre J.A.
        • Rastogi A.
        • et al.
        Early postnatal dexamethasone therapy in premature infants with severe respiratory distress syndrome: a double-blind, controlled study.
        J Pediatr. 1990; 117: 273-282
        • Yeh T.F.
        • Lin Y.J.
        • Huang C.C.
        • et al.
        Early dexamethasone therapy in preterm infants: a follow-up study.
        Pediatrics. 1998; 101: e7
        • O’Shea T.M.
        • Kothadia J.M.
        • Klinepeter K.L.
        • et al.
        Randomized placebo-controlled trial of a 42-day tapering course of dexamethasone to reduce the duration of ventilator dependency in very low birth weight infants: outcome of study participants at 1-Year adjusted age.
        Pediatrics. 1999; 104: 15-21
        • Helbock H.J.
        • Insoft R.M.
        • Conte F.A.
        Glucocorticoid-responsive hypotension in extremely low birth weight newborns.
        Pediatrics. 1993; 92: 715-717
        • Watterberg K.L.
        • Gerdes J.S.
        • Gifford K.L.
        Prophylaxis against early adrenal insufficiency to prevent chronic lung disease in premature Infants.
        Pediatrics. 1999; 104: 1258-1263
        • Peltoniemi O.
        • Kari M.A.
        • Heinonen K.
        • et al.
        Pretreatment cortisol values may predict responses to hydrocortisone administration for the prevention of bronchopulmonary dysplasia in high-risk infants.
        J Pediatr. 2005; 146: 632-637
        • Bonsante F.
        • Latorre G.
        • Iacobelli S.
        • et al.
        Early low-dose hydrocortisone in very preterm infants: a randomized, placebo-controlled trial.
        Neonatology. 2007; 91: 217-221
        • Jack J.
        • Young S.B.
        Endocrinology.
        in: Hughes H.K. Kahl L.K. Harriet lane handbook. Elsevier, Philadelphia2018: 255-289
        • Watterberg K.L.
        Hydrocortisone dosing for hypotension in newborn infants: less is more.
        J Pediatr. 2016; 174: 23-26.e1
        • Vezina H.E.
        • Ng C.M.
        • Vazquez D.M.
        • et al.
        Population pharmacokinetics of unbound hydrocortisone in critically ill neonates and infants with vasopressor-resistant hypotension.
        Pediatr Crit Care Med. 2014; 15: 546-553
        • Mizobuchi M.
        • Yoshimoto S.
        • Nakao H.
        Time-course effect of a single dose of hydrocortisone for refractory hypotension in preterm infants: hydrocortisone for refractory hypotension.
        Pediatr Int. 2011; 53: 881-886
      1. Nguyen J, Thompson I, Wertheimer F, et al. Acetaminophen treatment is associated with closure of patent ductus arteriosus but may increase risk of intestinal perforation. E-PAS 2016: 3855.506. Presented at Pediatric Academic Societies's meeting in Baltimore, Maryland, April 30 - May 3, 2016.

        • Watterberg K.L.
        • Shaffer M.L.
        • Mishefske M.J.
        • et al.
        Growth and neurodevelopmental outcomes after early low-dose hydrocortisone treatment in extremely low birth weight infants.
        PEDIATRICS. 2007; 120: 40-48
        • Baud O.
        • Maury L.
        • Lebail F.
        • et al.
        Effect of early low-dose hydrocortisone on survival without bronchopulmonary dysplasia in extremely preterm infants (PREMILOC): a double-blind, placebo-controlled, multicentre, randomised trial.
        Lancet. 2016; 387: 1827-1836
        • Baud O.
        • Trousson C.
        • Biran V.
        • et al.
        Association between early low-dose hydrocortisone therapy in extremely preterm neonates and neurodevelopmental outcomes at 2 Years of age.
        JAMA. 2017; 317: 1329
        • Peltoniemi O.M.
        • Lano A.
        • Yliherva A.
        • et al.
        • for The Neonatal Hydrocortisone Working Group
        Randomised trial of early neonatal hydrocortisone demonstrates potential undesired effects on neurodevelopment at preschool age.
        Acta Paediatr. 2016; 105: 159-164
        • Parikh N.A.
        • Lasky R.E.
        • Kennedy K.A.
        • et al.
        Postnatal dexamethasone therapy and cerebral tissue volumes in extremely low birth weight infants.
        Pediatrics. 2007; 119: 265-272
        • Tam E.W.Y.
        • Chau V.
        • Ferriero D.M.
        • et al.
        Preterm cerebellar growth impairment after postnatal exposure to glucocorticoids.
        Sci Transl Med. 2011; 3: 105ra105
        • Lodygensky G.A.
        Structural and functional brain development after hydrocortisone treatment for neonatal chronic lung disease.
        Pediatrics. 2005; 116: 1-7
        • Rademaker K.J.
        • Uiterwaal C.S.P.M.
        • Groenendaal F.
        • et al.
        Neonatal hydrocortisone treatment: neurodevelopmental outcome and MRI at school age in preterm-born children.
        J Pediatr. 2007; 150: 351-357
        • Kersbergen K.J.
        • de Vries L.S.
        • van Kooij B.J.M.
        • et al.
        Hydrocortisone treatment for Bronchopulmonary Dysplasia and brain volumes in preterm infants.
        J Pediatr. 2013; 163: 666-671.e1
        • Benders M.J.
        • Groenendaal F.
        • van Bel F.
        • et al.
        Brain development of the preterm neonate after neonatal hydrocortisone treatment for chronic lung disease.
        Pediatr Res. 2009; 66: 555-559
        • Ng P.C.
        • Lam C.W.K.
        • Fok T.F.
        • et al.
        Refractory hypotension in preterm infants with adrenocortical insufficiency.
        Arch Dis Child. 2001; 84: F122-F124
        • Patra K.
        • Greene M.M.
        • Silvestri J.M.
        Neurodevelopmental impact of hydrocortisone exposure in extremely low birth weight infants: outcomes at 1 and 2 years.
        J Perinatol. 2015; 35: 77-81