• Erika Fernandez, Ron Schrader, and Kristi Watterberg.
• Department of Pediatrics/Neonatology (E.F., K.W.), The University of New Mexico Health Sciences Center, Albuquerque, NM 87131-0001, USA.
• J Perinatol. 2005 Feb 1;25(2):114-8.

ObjectiveTo determine the prevalence of low cortisol values and to evaluate clinical responses to hydrocortisone in ill term and near-term newborns.Study DesignRetrospective cohort study including infants >or=35 weeks gestational age who were mechanically ventilated, received vasopressor therapy, and had a cortisol concentration obtained for evaluation of vasopressor-resistant hypotension. In those infants treated with hydrocortisone, physiologic responses were evaluated and correlated with cortisol values (<15 vs >or=15 microg/dl).ResultsA total of 32 infants had cortisol values obtained; 18 (56%) were <15 microg/dl. In all, 21 infants were treated with hydrocortisone of whom 13 had cortisol values <15 microg/dl. These 13 infants showed decreased heart rate, dopamine support and fluid bolus requirements after treatment, compared to infants with values >or=15 microg/dl (n=8).ConclusionsA significant number of hypotensive, mechanically ventilated infants have evidence of inadequate adrenal function. Hydrocortisone therapy resulted in hemodynamic stabilization in this population.

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