| Title |
Steroid use for refractory hypotension in congenital diaphragmatic hernia
|
|---|---|
| Published in |
Pediatric Surgery International, July 2017
|
| DOI | 10.1007/s00383-017-4122-3 |
| Pubmed ID | |
| Authors |
Jason O. Robertson, Cory N. Criss, Lily B. Hsieh, Niki Matsuko, Josh S. Gish, Rodrigo A. Mon, Kevin N. Johnson, Samir K. Gadepalli |
| Abstract |
Guidelines for diagnosis and treatment of adrenal insufficiency (AI) in newborns with congenital diaphragmatic hernia (CDH) are poorly defined. From 2002 to 2016, 155 infants were treated for CDH at our institution. Patients with shock refractory to vasopressors (clinically diagnosed AI) were treated with hydrocortisone (HC). When available, random cortisol levels <10 μg/dL were considered low. Outcomes were compared between groups. Hydrocortisone was used to treat AI in 34% (53/155) of patients. That subset of patients was demonstrably sicker, and mortality was expectedly higher for those treated with HC (37.7 vs. 17.6%, p = 0.0098). Of the subset of patients with random cortisol levels measured before initiation of HC, 67.7% (21/31) had low cortisol levels. No significant differences were seen in survival between the high and low groups, but mortality trended higher in patients with high cortisol levels that received HC. After multivariate analysis, duration of HC stress dose administration was associated with increased risk of mortality (OR 1.11, 95% CI 1.02-1.2, p = 0.021), and total duration of HC treatment was associated with increased risk of sepsis (OR 1.04, 95% CI 1.005-1.075, p = 0.026). AI is prevalent amongst patients with CDH, but prolonged treatment with HC may increase risk of mortality and sepsis. |
Mendeley readers
The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 27 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 4 | 15% |
| Student > Doctoral Student | 4 | 15% |
| Student > Bachelor | 4 | 15% |
| Student > Postgraduate | 2 | 7% |
| Professor > Associate Professor | 2 | 7% |
| Other | 3 | 11% |
| Unknown | 8 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 33% |
| Nursing and Health Professions | 2 | 7% |
| Immunology and Microbiology | 1 | 4% |
| Social Sciences | 1 | 4% |
| Psychology | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 13 | 48% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 July 2017.
All research outputs
#20,434,884
of 22,988,380 outputs
Outputs from Pediatric Surgery International
#950
of 1,264 outputs
Outputs of similar age
#273,386
of 313,514 outputs
Outputs of similar age from Pediatric Surgery International
#10
of 25 outputs
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