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

Journal of Perinatology volume 33, pages 698–702 (2013)Cite this article

Subjects

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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Acknowledgements

Dr Lightburn was supported by the University of Arkansas for Medical Sciences Children’s University Medical Group. Dr Kaiser was supported by the National Institutes of Health (1K23NS43185, RR20146, and 1R01NS060674) and the University of Arkansas for Medical Sciences Translational Research Institute (1UL1RR029884). The technical assistance of Natalie C Sikes and Melanie J Mason, and the support of the University of Arkansas for Medical Sciences neonatologists, NICU nurses, respiratory therapists and ultrasound technicians, are gratefully appreciated.

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Authors and Affiliations

  1. Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    M H Lightburn

  2. Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    C H Gauss & D K Williams

  3. Department of Pediatrics Baylor College of Medicine, Houston, TX, USA

    J R Kaiser

  4. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA

    J R Kaiser

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  1. M H Lightburn
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Correspondence to J R Kaiser.

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The authors declare no conflict of interest.

Additional information

This research was presented in part at the Pediatric Academic Society, Society for Pediatric Research meeting in Vancouver, British Columbia, Canada, May 2010.

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Lightburn, M., Gauss, C., Williams, D. et al. Observational study of cerebral hemodynamics during dopamine treatment in hypotensive ELBW infants on the first day of life. J Perinatol 33, 698–702 (2013). https://doi.org/10.1038/jp.2013.44

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