Intensive care corticosteroids for critical neonatal conditions (review)
- Authors: Aleksandrovich Y.S.1, Ivanov D.O.1, Pshenisnov K.V.1, Sterlyagova E.V.1, Fomin S.A.1
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Affiliations:
- Saint Petersburg State Pediatric Medical University
- Issue: Vol 15, No 2 (2024)
- Pages: 71-83
- Section: Reviews
- URL: https://journals.eco-vector.com/pediatr/article/view/636248
- DOI: https://doi.org/10.17816/PED15271-83
- ID: 636248
Cite item
Abstract
Corticosteroids are widely used in clinical practice in the care of children in critical condition, but data on their efficacy in neonatal practice are very limited. This publication attempts to summarize and systematize the literature data on the use of exogenous corticosteroids in various diseases of the neonatal period. Special attention is paid to the pathophysiology of acute adrenal dysfunction in the structure of critical conditions, its diagnosis and treatment. The results of a number of studies confirming the effectiveness of various corticosteroids in neonatal cardiac surgery, arterial hypotension, neonatal sepsis, refractory septic shock, meconium aspiration syndrome and bronchopulmonary dysplasia are presented. It has been demonstrated that hydrocortisone is the drug of choice in critical situations due to its minimal half-life and low probability of side effects. It has been established that current data on the feasibility, efficacy and safety of corticosteroid use in critical conditions of the neonatal period are very controversial and require further experimental and clinical studies. The question of the necessity of corticosteroids use in neonatal cardiac surgery and in various lung diseases (meconium aspiration syndrome, bronchopulmonary dysplasia) remains open, although there is enough evidence of their positive therapeutic effect, but there are no randomized multicenter studies, which limits the use of corticosteroids in clinical practice. An absolute indication for the administration of corticosteroids in neonates is the presence of acute adrenal insufficiency, congenital adrenal cortical hyperplasia and catecholamine-resistant septic shock.
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About the authors
Yurii S. Aleksandrovich
Saint Petersburg State Pediatric Medical University
Author for correspondence.
Email: jalex1963@mail.ru
ORCID iD: 0000-0002-2131-4813
SPIN-code: 2225-1630
MD, PhD, Dr. Sci. (Medicine), Professor, Head of the Department of Anesthesiology and Intensive Care and Emergency Pediatrics Postgraduate Education
Russian Federation, 2 Litovskaya st., Saint Petersburg, 194100Dmitry O. Ivanov
Saint Petersburg State Pediatric Medical University
Email: doivanov@yandex.ru
ORCID iD: 0000-0002-0060-4168
SPIN-code: 4437-9626
MD, PhD, Dr. Sci. (Medicine), Professor, Chief Freelance Neonatologist of the Ministry of Health of Russia, rector, Head of the Department of Neonatology with Courses of Neurology and Obstetrics and Gynecology
Russian Federation, 2 Litovskaya st., Saint Petersburg, 194100Konstantin V. Pshenisnov
Saint Petersburg State Pediatric Medical University
Email: Psh_K@mail.ru
ORCID iD: 0000-0003-1113-5296
SPIN-code: 8423-4294
MD, PhD, Dr. Sci. (Medicine), Professor, Department of Anesthesiology and Intensive Care and Emergency Pediatrics, Faculty of Postgraduate and Additional Professional Education
Russian Federation, 2 Litovskaya st., Saint Petersburg, 194100
Ekaterina V. Sterlyagova
Saint Petersburg State Pediatric Medical University
Email: ekaterinasterlyagova@yandex.ru
ORCID iD: 0009-0006-6635-4313
Resident Doctor of the Department of Anesthesiology, Intensive Care and Emergency Pediatrics, Faculty of Postgraduate and Additional Professional Education
Russian Federation, 2 Litovskaya st., Saint Petersburg, 194100Sergey A. Fomin
Saint Petersburg State Pediatric Medical University
Email: doctor-fomin@mail.ru
ORCID iD: 0000-0001-7174-3512
SPIN-code: 2225-1630
postgraduate Student of the Department of Anesthesiology, Intensive Care and Emergency Pediatrics, Faculty of Postgraduate and Additional
Russian Federation, 2 Litovskaya st., Saint Petersburg, 194100References
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