Circulatory and diuretic effects of dopexamine infusion in low-birth-weight infants with respiratory failure

Intensive Care Med. 1996 Jan;22(1):65-70. doi: 10.1007/BF01728334.

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.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Acidosis, Respiratory / drug therapy
  • Blood Pressure / drug effects*
  • Diuresis / drug effects*
  • Dopamine / analogs & derivatives*
  • Dopamine / pharmacology
  • Dopamine / therapeutic use
  • Hemodynamics
  • Humans
  • Hypotension / drug therapy
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Infusions, Intravenous
  • Intensive Care, Neonatal
  • Oliguria / drug therapy
  • Prospective Studies
  • Respiratory Insufficiency / drug therapy*
  • Vasodilator Agents / pharmacology*
  • Vasodilator Agents / therapeutic use

Substances

  • Vasodilator Agents
  • dopexamine
  • Dopamine