Glucocorticosteroids may improve refractory hemodynamic instability in the systemic
inflammatory response syndrome, 1, 2 in which premature or stressed neonates may have
an inappropriate or abnormal adrenal response to stress. 3, 4 Over the past 3 years we have
attempted to use corticosteroids in infants with congenital heart disease on high-dose
epinephrine (0.15 g/kg/min), particularly when inotropic requirements have continued to
increase late after initial presentation or cardiac surgery. Our early observations in unstable …