P Kawczynski1, A Piotrowski. 1. Intensive Care Unit, Paediatric Hospital, University School of Medicine, Lodz, Poland.
Abstract
OBJECTIVE: To investigate the effects of infusion of dopexamine hydrochloride, a new synthetic catecholamine, on cardiopulmonary status and urine output in neonates with respiratory and circulatory failure. DESIGN: Prospective clinical study with each patient serving as his own control. SETTING: Intensive care unit (14 beds) in a 300-bed paediatric teaching hospital. PATIENTS: Seventeen neonates with low birth weight (LBW) requiring mechanical ventilation in the first 4 days of life, who initially had two of the following symptoms: hypotension, oliguria, metabolic acidosis with base deficit >10 and failure to respond to volume loading. INTERVENTIONS: Cardiopulmonary variables, diuresis and acid-base status were measured before and after volume loading, in patients who did not improve infusion of dopexamine was started at a dose of 2 microg kg-1 min-1 which was titrated to achieve blood pressure, urine output, and base deficit in normal range. Observations were continued for a period of 5 h. MEASUREMENTS AND RESULTS: Systolic blood pressure increased significantly after 3 h. of dopexamine infusion and remained elevated up to the end of the study period. Diastolic and mean blood pressure increased slightly (NS). Diuresis increased significantly from the 4th h of dopexamine infusion. Arterial blood pH increased significantly from baseline at 5 h after the start of dopexamine administration. There was also a significant improvement in the PtcO2/PaO2 index. CONCLUSION: In neonates with respiratory and circulatory failure, dopexamine increases blood pressure and improves arterial pH and urine output.
OBJECTIVE: To investigate the effects of infusion of dopexamine hydrochloride, a new synthetic catecholamine, on cardiopulmonary status and urine output in neonates with respiratory and circulatory failure. DESIGN: Prospective clinical study with each patient serving as his own control. SETTING: Intensive care unit (14 beds) in a 300-bed paediatric teaching hospital. PATIENTS: Seventeen neonates with low birth weight (LBW) requiring mechanical ventilation in the first 4 days of life, who initially had two of the following symptoms: hypotension, oliguria, metabolic acidosis with base deficit >10 and failure to respond to volume loading. INTERVENTIONS: Cardiopulmonary variables, diuresis and acid-base status were measured before and after volume loading, in patients who did not improve infusion of dopexamine was started at a dose of 2 microg kg-1 min-1 which was titrated to achieve blood pressure, urine output, and base deficit in normal range. Observations were continued for a period of 5 h. MEASUREMENTS AND RESULTS: Systolic blood pressure increased significantly after 3 h. of dopexamine infusion and remained elevated up to the end of the study period. Diastolic and mean blood pressure increased slightly (NS). Diuresis increased significantly from the 4th h of dopexamine infusion. Arterial blood pH increased significantly from baseline at 5 h after the start of dopexamine administration. There was also a significant improvement in the PtcO2/PaO2 index. CONCLUSION: In neonates with respiratory and circulatory failure, dopexamine increases blood pressure and improves arterial pH and urine output.
Authors: M R Bristow; R Ginsburg; V Umans; M Fowler; W Minobe; R Rasmussen; P Zera; R Menlove; P Shah; S Jamieson Journal: Circ Res Date: 1986-09 Impact factor: 17.367
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