Johnson Patricia J
Neonatal Netw. 2015;34(1):46-51. doi: 10.1891/0730-0832.34.1.46.
Newborns, and especially premature newborns, are at significant risk for developing hypotension in the first week or two after birth. The etiology of hypotension in the newborn may vary, but the very low birth weight and extremely low birth weight preterm infants are less likely to respond to conventional cardiovascular support when they develop hypotension. This article reviews the least conventional treatment using hydrocortisone for hypotension that is refractory to conventional volume replacement and/or vasopressor medications with the underlying assumption that sick and premature newborns have a relative or measured adrenal insufficiency. The addition of hydrocortisone in the treatment of hypotension in the newborn is becoming more common but is not universally advocated. However, the supportive evidence is growing, and, as reviewed, use of hydrocortisone requires judicious and cautious regard.
新生儿，尤其是早产儿，在出生后的头一两周内有发生低血压的重大风险。新生儿低血压的病因可能各不相同，但极低出生体重和超低出生体重的早产儿在发生低血压时，对传统的心血管支持措施反应较差。本文回顾了使用氢化可的松治疗对传统容量补充和/或血管加压药物治疗无效的低血压的非常规治疗方法，其基本假设是患病的早产儿存在相对或可测量的肾上腺功能不全。在新生儿低血压治疗中添加氢化可的松的情况越来越普遍，但并非得到普遍提倡。然而，支持性证据正在增加，如本文所述，使用氢化可的松需要审慎和谨慎对待。
