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Observational Study
. 2013 Sep;33(9):698-702.
doi: 10.1038/jp.2013.44. Epub 2013 Apr 25.

Observational study of cerebral hemodynamics during dopamine treatment in hypotensive ELBW infants on the first day of life

M H Lightburn  1 , C H Gauss, D K Williams, J R Kaiser
Affiliations
Observational Study

Observational study of cerebral hemodynamics during dopamine treatment in hypotensive ELBW infants on the first day of life

M H Lightburn et al. J Perinatol. 2013 Sep.

Abstract

Objective: To evaluate cerebral hemodynamics during dopamine treatment in hypotensive (mean arterial blood pressure (MABP)<gestational age) extremely low birth weight (ELBW) infants.

Study design: Continuous monitoring of cerebral blood flow velocity (CBFv), MABP and PCO2 was performed in hypotensive ELBW infants on the first day of life, beginning with an ∼15-min baseline reading and continued during advancing dopamine infusion until MABP was optimized. Physiological variables and CBFv reactivity were compared before and after MABP was optimized.

Result: Fifteen hypotensive ELBW infants (625±174 g; 24 (23 to 24.8) weeks) were studied. Mean CBFv increased from 10.9±3.7 to 15.7±5.7 cm s(-1) (P=0.001) simultaneously as MABP increased from 22.3±2.8 to 35.2±9.7 mm Hg (P<0.001). Mean CBFv reactivity (95% confidence interval (CI)) was 3.9 (1.6 to 6.2) %mm Hg(-1). Nine infants died and/or developed severe intraventricular hemorrhage (IVH).

Conclusion: Mean CBFv increased pressure-passively as MABP was optimized by dopamine treatment in very sick hypotensive ELBW infants on the first day of life.

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Conflict of interest statement

Conflict of interest

The authors declare no potential, perceived, or real conflicts of interest. The authors also declare there are no competing financial interests

Figures

Figure
Figure
Example of the effects of dopamine on MABP, PCO2, and mean CBFv in a hypotensive ELBW infant.
See this image and copyright information in PMC

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