{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:15:40Z","timestamp":1788974140844,"version":"build-2803163510"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can J Hosp Pharm"],"abstract":"<jats:p>Background: Hypotension is common among preterm and term neonates in the neonatal intensive care unit, particularly those with very low birth weight, sepsis, or hypoxic\u2013ischemic encephalopathy. Some remain hypotensive despite volume expansion and vasopressors, possibly due to relative adrenal insufficiency. Hydrocortisone is proposed as adjunct therapy, but its effect on mortality is uncertain.\nObjective: To evaluate whether IV hydrocortisone reduces all-cause mortality in neonates with hypotension.\nMethods: The MEDLINE, Embase, CENTRAL, and Scopus databases were searched up to March 30, 2025, for randomized controlled trials (RCTs) that compared IV hydrocortisone with placebo and reported mortality. Two reviewers independently screened the studies, extracted data, and assessed bias. A fixed-effects Mantel\u2013Haenszel meta-analysis was used, based on the degree of heterogeneity.\nResults: Five RCTs (with a total of 239 neonates) were included. Heterogeneity was low (I2 = 0%). Hydrocortisone significantly reduced mortality (odds ratio 0.48, 95% confidence interval 0.24\u20130.96).Conclusions: IV hydrocortisone may reduce mortality in refractory neonatal hypotension. However, larger trials are needed to confirm this finding.\nKeywords: hydrocortisone, hypotension, mortality, neonate\nR\u00c9SUM\u00c9\nContexte: L\u2019hypotension est fr\u00e9quente chez les nouveau-n\u00e9s pr\u00e9matur\u00e9s et \u00e0 terme en unit\u00e9 de soins intensifs n\u00e9onatals, particuli\u00e8rement chez ceux ayant un tr\u00e8s faible poids \u00e0 la naissance, une septic\u00e9mie ou une enc\u00e9phalopathie hypoxique-isch\u00e9mique. Certains restent hypotendus malgr\u00e9 l\u2019expansion vol\u00e9mique et l\u2019utilisation de vasopresseurs, possiblement en raison d\u2019une insuffisance surr\u00e9nalienne relative. L\u2019hydrocortisone est propos\u00e9e comme traitement adjuvant, mais son effet sur la mortalit\u00e9 est incertain.\nObjectif: \u00c9valuer si l\u2019hydrocortisone administr\u00e9e par IV r\u00e9duit la mortalit\u00e9 (toutes causes confondues) chez les nouveau-n\u00e9s atteints d\u2019hypotension.\nM\u00e9thodologie: Les bases de donn\u00e9es MEDLINE, Embase, CENTRAL et Scopus ont \u00e9t\u00e9 consult\u00e9es jusqu\u2019au 30 mars 2025 afin de rep\u00e9rer des essais contr\u00f4l\u00e9s randomis\u00e9s (ECR) comparant l\u2019hydrocortisone administr\u00e9e par IV \u00e0 un placebo et rapportant la mortalit\u00e9. Deux \u00e9valuateurs ont s\u00e9lectionn\u00e9 les \u00e9tudes de mani\u00e8re ind\u00e9pendante, extrait les donn\u00e9es et \u00e9valu\u00e9 le risque de biais. Une m\u00e9ta-analyse \u00e0 effets fixes selon la m\u00e9thode de Mantel\u2013Haenszel a \u00e9t\u00e9 utilis\u00e9e, en fonction du degr\u00e9 d\u2019h\u00e9t\u00e9rog\u00e9n\u00e9it\u00e9.\nR\u00e9sultats: Cinq ECR (comprenant 239 nouveau-n\u00e9s) ont \u00e9t\u00e9 retenus. L\u2019h\u00e9t\u00e9rog\u00e9n\u00e9it\u00e9 \u00e9tait faible (I2 = 0 %). L\u2019hydrocortisone a r\u00e9duit de fa\u00e7on significative la mortalit\u00e9 (rapport de cotes 0,48; intervalle de confiance \u00e0 95 %: 0,24-0,96).\nConclusions: L\u2019hydrocortisone administr\u00e9e par IV pourrait r\u00e9duire la mortalit\u00e9 en cas d\u2019hypotension n\u00e9onatale r\u00e9fractaire. Toutefois, des essais de plus grande envergure sont n\u00e9cessaires pour confirmer ce r\u00e9sultat.\nMots-cl\u00e9s: hydrocortisone, hypotension, mortalit\u00e9, nouveau-n\u00e9<\/jats:p>","DOI":"10.4212\/cjhp.3953","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:51:55Z","timestamp":1788972715000},"source":"Crossref","is-referenced-by-count":0,"title":["Effect of IV Hydrocortisone on Mortality among Neonates with Hypotension: A Systematic Review and Meta-analysis of Randomized, Placebo-Controlled Trials"],"prefix":"10.4212","volume":"79","author":[{"given":"Chia Siang","family":"Kow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaeshaelya","family":"Thiruchelvam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2732","published-online":{"date-parts":[[2026,9,9]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3953\/5953","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3953\/5960","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3953\/5953","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:51:56Z","timestamp":1788972716000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,9]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3953","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"value":"1920-2903","type":"electronic"},{"value":"0008-4123","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"e3953"}}