Glucocorticoid therapy for hypotension in the cardiac intensive care unit

In recent years, it has been our practice to treat persistent hypotension in the cardiac intensive care unit with glucocorticoids. We undertook a retrospective review in an attempt to identify predictors of a hemodynamic response to steroids and of survival in these patients. Patients who had receiv...

Full description

Saved in:
Bibliographic Details
Published in:Pediatric cardiology 2007-06, Vol.28 (3), p.176-182
Main Authors: Millar, K J, Thiagarajan, R R, Laussen, P C
Format: Article
Language:English
Subjects:
Age Factors
Blood Pressure - drug effects
Cardiotonic Agents - therapeutic use
Care and treatment
Child
Child, Preschool
Corticosteroids
Dopamine - therapeutic use
Glucocorticoids - therapeutic use
Health aspects
Heart Rate - drug effects
Humans
Hydrocortisone - blood
Hypotension
Hypotension - drug therapy
Hypotension - mortality
Infant
Infant, Newborn
Intensive Care Units, Pediatric
Logistic Models
Retrospective Studies
Statistics, Nonparametric
Urination - drug effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:In recent years, it has been our practice to treat persistent hypotension in the cardiac intensive care unit with glucocorticoids. We undertook a retrospective review in an attempt to identify predictors of a hemodynamic response to steroids and of survival in these patients. Patients who had received glucocorticoids for hypotension over a 2-year period were identified retrospectively. Summary measures of blood pressure, heart rate, urine output, inotrope score, and volume of infused fluid were calculated for the 12 hours before and the 24 hours following initiation of glucocorticoid therapy. A hemodynamic response was defined as a > or =20% increase in mean blood pressure without an increase in inotrope score following initiation of steroid therapy. Fifty-one patients were included, of whom 6 (11.8%) died. Serum cortisol was measured in 43 patients (84.3%) and was below the lower limit of normal (
ISSN:0172-0643
1432-1971
DOI:10.1007/s00246-006-0053-9