Mechanisms of blood pressure increase induced by dopamine in hypotensive preterm neonates
J Zhanga c, D J Pennya d, N S Kimd, V Y H Yub, J J Smolicha b
a Centre for Heart and
Chest Research Department of Medicine
Monash Medical Centre
246 Clayton Road
Clayton 3168 Victoria
Australia, b Department of Paediatrics, c Department of
Obstetrics and Gynaecology University of
Queensland Brisbane
Queensland Australia, d Department of Cardiology
Royal Children's Hospital
Parkville Victoria
Australia
Correspondence to: Dr J J Smolich. Email: joe.smolich{at}med.monash.edu.au
Accepted 3 May 1999
AIMS
To compare
changes in global haemodynamics as well as anterior cerebral and
superior mesenteric artery perfusion after dopamine treatment.
METHODSAnterior
cerebal and superior mesenteric artery perfusion was measured using
Doppler ultrasonography in hypotensive preterm neonates in whom cardiac
output increased (group 1, n=10) or decreased (group 2, n=40) after
dopamine treatment.
RESULTSDespite a
lower dopamine infusion rate, the blood pressure increase (mm Hg) in
group 2 [
=13(1); mean(SE)] exceeded that in group 1 [=8(1)],
while systemic vascular resistance (mm Hg/l/min/kg) rose in group 2 [=106 (37)], but was unchanged in group 1 [=9 (6)]. Anterior
cerebral artery blood velocity and resistance were unaffected by
dopamine. However, compared with unchanged values in group 1, superior
mesenteric artery blood velocity fell by 14.7(4.8) cm/s and resistance
increased by 4.1(0.7) mm Hg/cm in group 2.
CONCLUSIONSThese
results suggest that, in a portion of hypotensive preterm neonates, the
increase in blood pressure induced by dopamine is related to a
predominant vasoconstrictor action and is associated with a fall in
bowel perfusion.
Keywords: dopamine; hypotension; preterm infants
© 1999 by Archives of Disease in Childhood
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