Rescue Glucocorticoid Therapy in Extremely Preterm Infants

Refractory hypotension and chronic lung disease are common and lethal complications in extremely low gestational age newborns. Recently, glucocorticoids have been used as rescue therapy for these diseases based on the proposed contribution of relative adrenal insufficiency. However, the efficacy and safety, and optimal treatment protocol of glucocorticoids have not been established. We recently reported the potency of our therapeutic protocol for postnatal refractory hypotension with a single low dose of hydrocortisone. We also reported the efficacy of our therapeutic protocol with hydrocortisone for severe leaky lung syndrome, which occurs in the progression phase of chronic lung disease. To determine the efficacy and safety of these strategies, further well-designed randomized controlled trials are necessary.