Martinez A M, Padbury J F, Thio S
King-Drew Medical Center, UCLA School of Medicine.
Pediatrics. 1992 Jan;89(1):47-51.
The pharmacokinetics and pharmacodynamics of dobutamine were studied in 13 critically ill neonates requiring inotropic support. Dobutamine was administered as a constant infusion in increasing doses of 2.5, 5, and 7.5 micrograms/kg per minute. During dobutamine infusions, there were significant increases in cardiac output measurements above perinfusion values. There were no statistically significant changes in systolic or diastolic blood pressure or heart rate during the infusions. The mean calculated threshold value, or the minimum plasma concentration necessary for a change in cardiac output, was 39 +/- 8 ng/mL. The mean plasma clearance rate was 90 +/- 38 mL/min per kilogram and was most consistent with first-order kinetics over the range of dosages studied. Plasma catecholamine levels were unchanged during the dobutamine infusions. These data suggest that dobutamine is an effective but limited inotropic agent in the neonate. Dobutamine may be most beneficial when cardiogenic failure is presented.
在13名需要进行强心支持的危重新生儿中研究了多巴酚丁胺的药代动力学和药效学。多巴酚丁胺以每分钟2.5、5和7.5微克/千克的递增剂量持续输注给药。在多巴酚丁胺输注期间，心输出量测量值较输注前显著增加。输注期间收缩压或舒张压以及心率无统计学显著变化。计算得出的平均阈值，即心输出量发生变化所需的最低血浆浓度为39±8纳克/毫升。平均血浆清除率为每分钟每千克90±38毫升，在所研究的剂量范围内最符合一级动力学。多巴酚丁胺输注期间血浆儿茶酚胺水平未发生变化。这些数据表明，多巴酚丁胺在新生儿中是一种有效的但作用有限的强心剂。当出现心源性衰竭时，多巴酚丁胺可能最为有益。
