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氢化可的松在危重新生儿低血压应用中的研究进展
作者:胡莉鸿  梁道新  熊茂婷  邓佳红  赵婧 
单位:川北医学院附属医院 新生儿科, 四川 南充 637000
关键词:氢化可的松  危重新生儿  低血压  综述 
分类号:R722
出版年·卷·期(页码):2025·53·第五期(858-862)
摘要:

低血压是危重新生儿生后需面临的重要挑战之一。危重新生儿由于心肌细胞发育不成熟、肾上腺皮质功能低下、感染及正压通气等容易出现低血压,且多是难以纠正的低血压。在常规液体复苏及正性肌力药物无法纠正的情况下,需使用糖皮质激素来维持血压正常。但目前对于氢化可的松在新生儿低血压中的应用存在争议,对其适应证及治疗方案等问题缺乏共识,本文作者就氢化可的松在危重新生儿低血压中的应用进行综述。

参考文献:

[1] KUMBHAT N,NOORI S.Corticosteroids for neonatal hypotension[J].Clin Perinatol,2020,47(3):549-562.
[2] GRACE E,KEIR A K.Fluid therapy:friend or foe?[J].Clin Perinatol,2020,47(3):515-528.
[3] MULLALY R,EL-KHUFFASH A F.Haemodynamic assessment and management of hypotension in the preterm[J].Arch Dis Child Fetal Neonatal Ed,2024,109(2):120-127.
[4] IIJIMA S.Late-onset glucocorticoid-responsive circulatory collapse in premature infants[J].Pediatr Neonatol,2019,60(6):603-610.
[5] STRANAK Z,SEMBEROVA J,BARRINGTON K,et al.International survey on diagnosis and management of hypotension in extremely preterm babies[J].Eur J Pediatr,2014,173(6):793-798.
[6] OSBORN D A.Diagnosis and treatment of preterm transitional circulatory compromise[J].Early Hum Dev,2005,81(5):413-422.
[7] RIOS D R,MOFFETT B S,KAISER J R.Trends in pharmacotherapy for neonatal hypotension[J].J Pediatr,2014,165(4):697-701.e1.
[8] AUTRET-LECA E,BAUER S,ALBERTI C,et al.Glucocorticoide therapy in premature infants:French practices in 2006[J].Arch Pediatr,2009,16(7):999-1004.
[9] BAKER C W,BARKS J E,ENGMANN C,et al.Hydrocortisone administration for the treatment of refractory hypotension in critically ill newborns[J].J Perinatol,2008,28(6):412-419.
[10] HIGGINS S,FRIEDLICH P,SERI I.Hydrocortisone for hypotension and vasopressor dependence in preterm neonates:a meta-analysis[J].J Perinatol,2010,30(6):373-378.
[11] HOLMSTROM L E,JNAH A J.Relative adrenal insufficiency:crisis averted?[J].Neonatal Netw,2021,40(6):369-376.
[12] ALI S R,BRYCE J,KRONE N P,et al.Management of acute adrenal insufficiency-related adverse events in children with congenital adrenal hyperplasia:results of an international survey of specialist centres[J].Horm Res Paediatr,2022,95(4):363-373.
[13] JOHNSON P J.Hydrocortisone for treatment of hypotension in the newborn[J].Neonatal Netw,2015,34(1):46-51.
[14] RADOMSKI M W,PALMER R M,MONCADA S.Glucocorticoids inhibit the expression of an inducible,but not the constitutive,nitric oxide synthase in vascular endothelial cells[J].Proc Natl Acad Sci USA,1990,87(24):10043-10047.
[15] FERNANDEZ E F,MONTMAN R,WATTERBERG K L.ACTH and Cortisol response to critical illness in term and late preterm newborns[J].J Perinatol,2008,28(12):797-802.
[16] MORABITO L A,CORICA D,PEPE G,et al.Critical illness-related corticosteroid insufficiency(CIRCI) in paediatric patients:a diagnostic and therapeutic challenge[J].Ital J Pediatr,2024,50(1):46.
[17] MASUMOTO K,KUSUDA S.Hemodynamic support of the micropreemie:should hydrocortisone never be left out?[J].Semin Fetal Neonatal Med,2021,26(3):101222.
[18] HOCHWALD O,PELLIGRA G,OSIOVICH H.Adding hydrocortisone as 1st line of inotropic treatment for hypotension in very low birth weight infants:authors' reply[J].Indian J Pediatr,2014,81(9):988.
[19] HELBOCK H J,INSOFT R M,CONTE F A.Glucocorticoid-responsive hypotension in extremely low birth weight newborns[J].Pediatrics,1993,92(5):715-717.
[20] NG P C,LAM C W,FOK T F,et al.Refractory hypotension in preterm infants with adrenocortical insufficiency[J].Arch Dis Child Fetal Neonatal Ed,2001,84(2):F122-F124.
[21] MIZOBUCHI M,YOSHIMOTO S,NAKAO H.Time-course effect of a single dose of hydrocortisone for refractory hypotension in preterm infants[J].Pediatr Int,2011,53(6):881-886.
[22] WU T W,NOORI S.Recognition and management of neonatal hemodynamic compromise[J].Pediatr Neonatol,2021,62(Suppl 1):S22-S29.
[23] TEIXEIRA L S,SHIVANANDA S P,STEPHENS D,et al.Postoperative cardiorespiratory instability following ligation of the preterm ductus arteriosus is related to early need for intervention[J].J Perinatol,2008,28(12):803-810.
[24] CLYMAN R I,WICKREMASINGHE A,ALLEN MERRITT T,et al.Hypotension following patent ductus arteriosus ligation:the role of adrenal hormones[J].J Pediatr,2014,164(6):1449-1455.e1.
[25] SEHGAL A,FRANCIS J V,JAMES A,et al.Patent ductus arteriosus ligation and post-operative hemodynamic instability:Case report and framework for enhanced neonatal care[J].Indian J Pediatr,2010,77(8):905-907.
[26] SATPUTE M D,DONOHUE P K,VRICELLA L,et al.Cardiovascular instability after patent ductus arteriosus ligation in preterm infants:the role of hydrocortisone[J].J Perinatol,2012,32(9):685-689.
[27] AZZOPARDI D V,STROHM B,EDWARDS D A,et al.Moderate hypothermia to treat perinatal asphyxial encephalopathy[J].N Engl J Med,2009,361(14):1349-1358.
[28] BALOG V,VATAI B,KOVACS K,et al.Time series analysis of non-invasive hemodynamic monitoring data in neonates with hypoxic-ischemic encephalopathy[J].Front Pediatr,2023,11:1112959.
[29] KOVACS K,SZAKMAR E,MEDER U,et al.A randomized controlled study of low-dose hydrocortisone versus placebo in dopamine-treated hypotensive neonates undergoing hypothermia treatment for hypoxic-ischemic encephalopathy[J].J Pediatr,2019,211:13-19.e3.
[30] MORAN P,SULLIVAN K,ZANELLI S A,et al.Single-center experience with therapeutic hypothermia for hypoxic-ischemic encephalopathy in infants with <36 weeks' gestation[J].Am J Perinatol,2024,41(12):1680-1687.
[31] KHARRAT A,JAIN A.Hemodynamic dysfunction in neonatal sepsis[J].Pediatr Res,2022,91(2):413-424.
[32] DEN BRINKER M,JOOSTEN K F M,LIEM O,et al.Adrenal insufficiency in meningococcal sepsis:bioavailable Cortisol levels and impact of interleukin-6 levels and intubation with etomidate on adrenal function and mortality[J].J Clin Endocrinol Metab,2005,90(9):5110-5117.
[33] WYNN J L,WONG H R.Pathophysiology and treatment of septic shock in neonates[J].Clin Perinatol,2010,37(2):439-479.
[34] ZIELISKA K A,VAN MOORTEL L,OPDENAKKER G,et al.Endothelial response to glucocorticoids in inflammatory diseases[J].Front Immunol,2016,7:592.
[35] DELLINGER P R,LEVY M M,RHODES A,et al.Surviving sepsis campaign:international guidelines for management of severe sepsis and septic shock:2012[J].Crit Care Med,2013,41(2):580-637.
[36] DAVIS A L,CARCILLO J A,ANEJA R K,et al.American college of critical care medicine clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock[J].Crit Care Med,2017,45(6):1061-1093.
[37] HAN Y Y,CARCILLO J A,DRAGOTTA M A,et al.Early reversal of pediatric-neonatal septic shock by community physicians is associated with improved outcome[J].Pediatrics,2003,112(4):793-799.
[38] KHARRAT A,DIAMBOMBA Y,JAIN A.Corticosteroid use in neonatal hypotension:a survey of Canadian neonatologists[J].Pediatr Neonatol,2024,65(5):451-456.
[39] FOOTE H P,BENJAMIN D K,GREENBERG R G,et al.Use of vasopressors for septic shock in the neonatal intensive care unit[J].J Perinatol,2023,43(10):1274-1280.
[40] ALTIT G,VIGNY-PAU M,BARRINGTON K,et al.Corticosteroid therapy in neonatal septic shock-do we prevent death?[J].Am J Perinatol,2018,35(2):146-151.
[41] KLOOSTERBOER S,ANOLDA N F B,HEYMAN H,et al.A preliminary study of correlates of premature birth and their influence on Cortisol levels in young children[J].Biol Res Nurs,2024,26(2):240-247.
[42] BURGUNDER L,HEYREND C,OLSON J,et al.Medication and fluid management of pediatric sepsis and septic shock[J].Paediatr Drugs,2022,24(3):193-205.
[43] MENON K,LAWSON M.Identification of adrenal insufficiency in pediatric critical illness[J].Pediatr Crit Care Med,2007,8(3):276-278.
[44] DEMIRAL M,KIRAL E,DINLEYICI E C,et al.Evaluation of the hypothalamic-pituitary-adrenal axis in a paediatric intensive care unit[J].Acta Endocrinol(Buchar),2019,15(4):466-471.
[45] IBRAHIM H,SINHA I P,SUBHEDAR N V.Corticosteroids for treating hypotension in preterm infants[J].Cochrane Database Syst Rev,2011,2011(12):CD003662.

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