Glucocorticoids may improve lung function in newborns with
meconium aspiration syndrome (MAS), but information on the acute side effects of
glucocorticoids in infants is limited. In this study using a rabbit model of MAS, we addressed the hypothesis that systemic administration of
dexamethasone causes acute cardiovascular changes. Adult rabbits were treated with 2 intravenous doses of
dexamethasone (0.5 mg/kg each) or saline at 0.5 h and 2.5 h after intratracheal instillation of human meconium or saline. Animals were
oxygen-ventilated for 5 h after the first dose of treatment. Blood pressure, heart rate, and short-term heart rate variability (HRV) were analyzed during treatment, for 5 min immediately after each dose, and for the 5 h of the experiment. In the meconium-instilled animals,
dexamethasone increased blood pressure, decreased heart rate, increased HRV parameters, and caused
cardiac arrhythmia during and immediately after administration. In the saline-instilled animals, the effect of
dexamethasone was inconsistent. In these animals, the acute effects of
dexamethasone on blood pressure and cardiac rhythm were reversed after 30 min, whereas heart rate continued to decrease and HRV parameters continued to increase for 5 h after the first dose of
dexamethasone. These effects were more pronounced in meconium-instilled animals. If systemic
glucocorticoids are used in the treatment of MAS, cardiovascular side effects of
glucocorticoids should be considered.