Pediatr Surg Int (2017) 33:981–987 DOI 10.1007/s00383-017-4122-3 ORIGINAL ARTICLE Steroid use for refractory hypotension in congenital diaphragmatic hernia 1 1 1 1 • • • • Jason O. Robertson Cory N. Criss Lily B. Hsieh Niki Matsuko 1 1 1 1 • • • Josh S. Gish Rodrigo A. Mon Kevin N. Johnson Samir K. Gadepalli Accepted: 27 June 2017 / Published online: 6 July 2017 Springer-Verlag GmbH Germany 2017 Abstract Keywords Adrenal insufﬁciency Stress dose Congenital Purpose Guidelines for diagnosis and treatment of adrenal diaphragmatic hernia Steroids insufﬁciency (AI) in newborns with congenital diaphrag- matic hernia (CDH) are poorly deﬁned. Methods From 2002 to 2016, 155 infants were treated for Introduction CDH at our institution. Patients with shock refractory to vasopressors (clinically diagnosed AI) were treated with The ability to secrete cortisol in response to increased hydrocortisone (HC). When available, random cortisol physiologic demands is an essential part of the body’s levels \10 lg/dL were considered low. Outcomes were response to stress. Inadequate production of endogenous compared between groups. cortisol during severe illness is termed adrenal insufﬁ- Results Hydrocortisone was used to treat AI in 34% (53/ ciency (AI) and is associated with vasopressor-resistant 155)
Pediatric Surgery International – Springer Journals
Published: Jul 6, 2017
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