Abstract
Background:
A full consensus has not been reached about the hemodynamic efficacy of hydrocortisone administration in hypotensive and vasopressor-dependent preterm neonates.
Objective:
To examine the efficacy of hydrocortisone for treatment of hypotension and reduction of vasopressor requirements in preterm infants.
Method:
Standard meta-analytic techniques, including random and fixed effects models, were used to calculate combined effect size correlations and significance levels.
Result:
Random effects meta-analysis showed that hydrocortisone increases blood pressure (seven studies; N=144; r=0.71, 95%CI=0.18 to 0.92) and reduces vasopressor requirement (five studies; N=93; r=0.74, 95%CI=0.0084 to 0.96). The number of new or unretrieved studies averaging null results required to increase the overall p to 0.05 is k=78 for blood pressure increase and k=47 for vasopressor requirement reduction.
Conclusion:
The effects of hydrocortisone on increasing blood pressure and decreasing vasopressor requirements in preterm infants are robust with a large tolerance for future null results. Actual clinical benefits of increasing blood pressure and decreasing vasopressor requirements, however, remain unknown. Long-term sequelae of hydrocortisone administration have yet to be fully elucidated.
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Higgins, S., Friedlich, P. & Seri, I. Hydrocortisone for hypotension and vasopressor dependence in preterm neonates: A meta-analysis. J Perinatol 30, 373–378 (2010). https://doi.org/10.1038/jp.2009.126
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DOI: https://doi.org/10.1038/jp.2009.126
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