The use of dopamine in children.

Dopamine was used as the primary catecholamine to treat circulatory shock, manifested by either systemic arterial hypotension or oliguria or both, in 24 children two days to 18 years (mean = 39 months) of age. The dose of dopamine ranged from 0.3 to 25 (mean = 9.3) microgram/kg/minute. The primary problem in four of the 24 patients was infection; two of these patients survived. The other 20 patients had congenital heart disease; 18 developed shock following surgery. Even of these 20 patients survived. With dopamine infusion the average systolic blood pressure increased from 69 +/- 4 (mean +/- SEM) to 81 +/- 4 mm Hg (P less than 0.001) and the mean urine output increased from 0.8 +/- 0.2 to 2.7 +/- 0.8 ml/kg/hour (P less than 0.05). Dopamine produced no adverse consequences. Thirteen patients responded favorably to the drug, with a significant increase in systemic arterial blood pressure and urine production. Four patients did not respond to dopamine and seven had an equivocal response. None of the four patients in whom dopamine was ineffective survived. Although only nine of the 20 patients who responded favorably or equivocally survived, conventional therapy had failed to alter the unfavoarble course in any of the patients.