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Abstract
Cortisol release in the face of illness or stress is vital for survival. Relative
adrenal insufficiency occurs when a patient's cortisol response is inadequate for
the degree of illness or stress. Numerous studies have documented the existence of
relative adrenal insufficiency in critically ill adults, and its association with
increased morbidity and mortality. There is increasing evidence that relative adrenal
insufficiency may be an etiology for hemodynamic instability and hypotension in the
critically ill newborn, but compared with the adult population, there is still a paucity
of data in this population. Randomized controlled trials are needed to evaluate the
efficacy and safety of glucocorticoids for the treatment of cardiovascular insufficiency
due to relative adrenal insufficiency in ill preterm and term newborn infants.