AI Article Synopsis
- The concept of relative adrenal insufficiency is under scrutiny in critically ill newborns, particularly preterm infants, with its impact on hemodynamic stability being a key focus.
- Many preterm infants show low serum cortisol levels which often improve with steroid treatment, suggesting a temporary condition linked to their stage of development.
- More extensive and rigorous studies are necessary to establish clear guidelines for diagnosing and treating adrenal insufficiency in this vulnerable population.
Article Abstract
Purpose Of Review: Relative adrenal insufficiency is a controversial phenomenon described in adults and children with critical illness, especially septic shock. In the past 2 decades, relative adrenal insufficiency has also been reported in the critically ill premature as well as term newborn. The present study will review the initial and more recent studies addressing adrenal insufficiency in the premature infant.
Recent Findings: Studies suggest that 'relative adrenal insufficiency' is a contributing factor to hemodynamic instability in the sick preterm newborn. Many ill preterm newborns have inappropriately low serum cortisol concentrations and respond to steroid administration. Adrenal insufficiency is transient and likely reflects normal adrenal physiology at younger gestational ages. There is no general consensus on its diagnosis, effective minimum dose for treatment and duration of treatment.
Summary: More large scale, multicenter, randomized, double-blind studies are needed to make the diagnosis of relative adrenal insufficiency and to determine the indication, dose, complications and outcome of glucocorticoid therapy.
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| http://dx.doi.org/10.1097/MED.0b013e32833363cc | DOI Listing |
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