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Corticosteroids for treating hypotension in preterm infants.

Hafis Ibrahim¹, Ian P Sinha, Nimish V Subhedar

¹Neonatal Intensive Care Unit, Liverpool Women's Hospital, Liverpool, UK, L8 7SS.

The Cochrane Database of Systematic Reviews

|December 14, 2011

Summary

Corticosteroids effectively treat refractory hypotension in preterm infants, reducing persistent hypotension. However, long-term safety and benefits remain unknown, precluding routine use.

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Transcutaneous Microcirculatory Imaging in Preterm Neonates

Transcutaneous Microcirculatory Imaging in Preterm Neonates

Published on: December 31, 2015

Area of Science:

Neonatal Medicine
Pediatric Pharmacology
Clinical Trials

Background:

Systemic hypotension is a common complication in preterm infants, linked to adverse neurodevelopmental outcomes.
Corticosteroids are explored as an alternative or adjunct to conventional hypotension treatments like volume expansion and vasopressors.

Purpose of the Study:

To evaluate the effectiveness and safety of corticosteroids for treating hypotension in preterm infants.
To assess corticosteroids as both primary treatment and for refractory hypotension.

Main Methods:

Systematic review of randomized or quasi-randomized controlled trials.
Searched multiple databases (Cochrane, MEDLINE, EMBASE, CINAHL) and conference abstracts.
Assessed methodological quality and analyzed data using standard meta-analysis techniques.

Main Results:

Four studies with 123 infants were analyzed.
Corticosteroids were less effective than dopamine as a primary treatment for hypotension.
Steroids significantly reduced persistent hypotension in infants with refractory hypotension compared to placebo (NNT=2.1).

Conclusions:

Corticosteroids show effectiveness in treating refractory hypotension in preterm infants without short-term adverse effects.
Long-term safety and benefit data for corticosteroid use in preterm infant hypotension are lacking.
Routine use of corticosteroids for hypotension in preterm infants is not recommended due to insufficient long-term data.