Adrenocortical function in the postoperative pediatric cardiac surgical patient

Michael L. Green, Josh Koch

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


Purpose of Review: Corticosteroids are frequently used in the postoperative care of children with congenital heart disease. This review describes the function of the adrenocortical axis in this population and the effects of corticosteroids on cardiovascular function. In addition, it examines the diagnosis of adrenal insufficiency in this population and provides an overview of recent studies on the use of steroids in treating hemodynamic instability in these children. Recent findings: Corticosteroids improve hemodynamic parameters in children with shock following congenital heart surgery. This improvement may be due to treatment of adrenal insufficiency or from direct cardiovascular effects of corticosteroids. The diagnosis of adrenal insufficiency in this population is challenging as low cortisol levels do not consistently correlate with adverse outcomes. Summary: Because of the lack of evidence delineating what the normal adrenocortical function is in this population, cortisol levels alone are not sufficient to justify treating with steroids in this population. Corticosteroids are beneficial in improving hemodynamics in children with shock after congenital heart surgery, but the adverse effects of the therapy in this context are not fully known. Prospective trials are necessary to clarify which patients may benefit from steroid therapy and to examine long-term effects of steroids.

Original languageEnglish (US)
Pages (from-to)285-290
Number of pages6
JournalCurrent opinion in pediatrics
Issue number3
StatePublished - Jun 1 2012


  • adrenal
  • children
  • congenital heart surgery
  • corticosteroids

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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