Kawai Masahiko
Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Pediatr Int. 2017 Apr;59(4):391-396. doi: 10.1111/ped.13242.
Late-onset circulatory collapse (LCC) is a refractory hypotension occurring after the early neonatal period (>day 7), in very low-birthweight infants. Typically, infants stabilized within the early neonatal period develop sudden onset of circulatory collapse after the early neonatal period. The underlying pathophysiology of LCC is considered to be relative adrenal insufficiency, which is well known in Japan, but is not widely accepted in North America or Europe. The current increase in LCC in Japan suggests that the principal trigger is related to recent trends in neonatal medicine and/or newly introduced treatments for preterm infants, but the pathophysiology has not been fully elucidated. In this review, based on current knowledge regarding LCC, the pathophysiology is discussed.
迟发性循环衰竭（LCC）是指在极低出生体重儿的早期新生儿期（>7 天）之后发生的难治性低血压。通常，在早期新生儿期病情稳定的婴儿在该时期之后会突然发生循环衰竭。LCC 的潜在病理生理学被认为是相对肾上腺皮质功能不全，这在日本广为人知，但在北美或欧洲并未被广泛接受。目前日本 LCC 病例的增加表明主要触发因素与新生儿医学的近期趋势和/或新引入的早产儿治疗方法有关，但病理生理学尚未完全阐明。在本综述中，基于目前关于 LCC 的知识，对其病理生理学进行了讨论。
