Patient's question:
A newborn has congenital adrenal hyperplasia, currently taking 2.5 mL of hydrocortisone every eight hours and 0.1 g of fludrocortisone daily. How is the current condition?Doctor's answer:
Hypovolemic shock: Intravenous fluids can be administered with normal saline. If metabolic acidosis is present, use a 0.45% sodium chloride and sodium bicarbonate solution. Avoid potassium-containing solutions.Severe hypovolemic shock requires intravenous infusion of hydrocortisone. If hyponatremia and dehydration are difficult to correct, intramuscular injection of hydrocortisone acetate (DOCA) or oral fludrocortisone may be administered. After dehydration is corrected, the glucocorticoid should be switched to oral administration and maintained long-term, along with oral sodium chloride. The dosage can be adjusted appropriately based on the condition.
If any discomfort occurs, it is recommended to seek medical follow-up at a hospital.