BACKGROUND: Intravenous hydrocortisone (HC) is often used in very low birth weight infants (VLBW) but can be complicated by oliguria when discontinued or tapered. OBJECTIVES: To determine which factors were associated with oliguria during HC taper. METHODS: We reviewed all VLBW infants who received initial doses of HC ≥ 1 mg/kg/d. The initial dose and duration of HC, and the incidence of oliguria (urine output [UO] < 2 mL/kg/h) during HC taper, were recorded. In those with oliguria, we recorded the change in UO (mL/kg/h), blood pressure, and creatinine. RESULTS: The mean initial HC dose was 2.8 ± 1 mg/kg/d, and the mean total duration of HC therapy was 23 ± 25 days. Oliguria occurred in 24% (13/54) of treated infants. These infants were exposed to higher and longer duration of the initial HC dose than infants without oliguria. Oliguria was predicted by the initial HC dose (odds ratio [OR] 5.8, 95% confidence interval [CI] 1.3-25.8, p = 0.02) and by the number of days at initial dose (OR 1.7, 95%CI 1.1-2.7, p = 0.03). CONCLUSIONS: Oliguria during HC dosage weaning was associated with higher initial HC exposure. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
BACKGROUND: Intravenous hydrocortisone (HC) is often used in very low birth weight infants (VLBW) but can be complicated by oliguria when discontinued or tapered. OBJECTIVES: To determine which factors were associated with oliguria during HC taper. METHODS: We reviewed all VLBW infants who received initial doses of HC ≥ 1 mg/kg/d. The initial dose and duration of HC, and the incidence of oliguria (urine output [UO] < 2 mL/kg/h) during HC taper, were recorded. In those with oliguria, we recorded the change in UO (mL/kg/h), blood pressure, and creatinine. RESULTS: The mean initial HC dose was 2.8 ± 1 mg/kg/d, and the mean total duration of HC therapy was 23 ± 25 days. Oliguria occurred in 24% (13/54) of treated infants. These infants were exposed to higher and longer duration of the initial HC dose than infants without oliguria. Oliguria was predicted by the initial HC dose (odds ratio [OR] 5.8, 95% confidence interval [CI] 1.3-25.8, p = 0.02) and by the number of days at initial dose (OR 1.7, 95%CI 1.1-2.7, p = 0.03). CONCLUSIONS:Oliguria during HC dosage weaning was associated with higher initial HC exposure. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Justin B Josephsen; Brianna M Hemmann; Connie D Anderson; Brett M Hemmann; Paula M Buchanan; Howard L Williams; Lisa M Lubsch; Noah H Hillman Journal: J Perinatol Date: 2021-11-01 Impact factor: 2.521