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Updated: Aug 10, 2026
13:13
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Low serum cortisol in term newborns with refractory hypotension
P Tantivit1, N Subramanian, M Garg
1Department of Pediatrics, USC School of Medicine, Los Angeles, USA.
Summary
Glucocorticoid therapy significantly improved blood pressure and stabilized clinical conditions in term newborns with refractory hypotension, suggesting potential benefits for infants with relative adrenal insufficiency.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
Background:
- Refractory hypotension in term infants is a critical condition requiring effective treatment.
- The role of adrenal insufficiency in neonatal hypotension is not fully understood.
Purpose of the Study:
- To assess baseline serum cortisol levels in term infants with refractory hypotension.
- To evaluate the clinical response to glucocorticoid therapy in this patient group.
Main Methods:
- Seven term newborns with refractory hypotension were enrolled.
- Serum cortisol levels were measured before glucocorticoid (dexamethasone) initiation.
- Hemodynamic parameters, inotrope use, urine output, and fluid administration were monitored post-therapy.
Main Results:
- Serum cortisol levels ranged from 2.0 to 15.4 micrograms/dl.
- Glucocorticoid therapy led to significant blood pressure improvement and vasopressor weaning within 72 hours.
- Urine output increased, and the need for volume expanders decreased post-therapy; all infants survived.
Conclusions:
- Glucocorticoids effectively improved hemodynamic stability in term infants with refractory hypotension.
- Low serum cortisol levels in these infants suggest relative adrenal insufficiency.
- Glucocorticoid therapy may be essential for a subset of critically ill term infants with hypotension.
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