Question
Newborns with congenital adrenal hyperplasia are currently taking 2.5mL of hydrocortisone every eight hours, as well as 0.1g of fludrocortisone daily. How is their current condition?
Answer
For hyponatremic patients, intravenous fluid replacement with physiological saline should be used. If metabolic acidosis occurs, a 0.45% sodium chloride and sodium bicarbonate solution should be administered. Potassium-containing solutions should be avoided. For severe hyponatremic patients, intravenous infusion of hydrocortisone is recommended. If low sodium and dehydration conditions are not easily improved, intramuscular injection of acetate corticosterone (DOCA) or oral fludrocortisone can be considered. After dehydration conditions improve, glucocorticoids should be switched to oral administration and maintained long-term. Additionally, oral sodium chloride should be taken. Dosage can be adjusted appropriately based on the condition. If there are any discomforts, it is recommended to visit the hospital for a follow-up consultation.