Single-dose dexamethasone treatment of hypotension in preterm infants

J Pediatr. 1999 Jun;134(6):701-5. doi: 10.1016/s0022-3476(99)70284-2.


Objective: To test the efficacy of single-dose dexamethasone (DXM) in the management of severe arterial hypotension of newborn infants. Our hypothesis was that epinephrine infusions could be discontinued in 70% of patients within 12 hours after DXM administration compared with 10% in the placebo group.

Study design: Twenty preterm infants (median birth weight 690 g, gestational age 28 weeks, age at intervention 2 days) who did not respond to a standardized treatment protocol (blood/colloid followed by dopamine infusion stepwise increased to 15 micrograms/kg and minute) were started on an epinephrine infusion and were randomly allocated to receive either DXM (0.25 mg/kg) or placebo intravenously. The primary outcome criterion was the need for an epinephrine infusion 12 hours after treatment.

Results: Three infants were excluded. Epinephrine infusion was discontinued in 5 of 8 infants with DXM but in only 1 of 9 infants in the control group. The duration of epinephrine infusion was significantly shorter in the DXM group (exact log-rank test, P =. 023).

Conclusions: DXM was effective for the management of severe arterial hypotension in preterm infants not responding to standardized treatment.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adrenergic Agonists / therapeutic use
  • Blood Pressure / drug effects
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use*
  • Double-Blind Method
  • Epinephrine / administration & dosage
  • Epinephrine / therapeutic use
  • Humans
  • Hypotension / drug therapy*
  • Hypotension / etiology
  • Infant, Newborn
  • Infant, Premature*
  • Prospective Studies
  • Time Factors


  • Adrenergic Agonists
  • Dexamethasone
  • Epinephrine