Bouissou Antoine, Rakza Thameur, Klosowski Serge, Tourneux Pierre, Vanderborght Marie, Storme Laurent
Department of Perinatal Medicine, Hôpital Jeanne de Flandre, CHRU Lille, France.
J Pediatr. 2008 Dec;153(6):790-4. doi: 10.1016/j.jpeds.2008.06.014.
To study the effects of dopamine on systemic arterial pressure (SAP) and systemic blood flow (SBF) (estimated with the superior vena cava [SVC] flow) in preterm infants with hypotension and patent ductus arteriosus (PDA).
Clinical and echocardiographic variables were measured before and 2 hours after starting dopamine in premature infants <32 weeks gestational age with PDA and systemic hypotension.
Seventeen premature infants were included (gestational age, 28+/-2 weeks; birth weight, 1030 +/- 400 g). A mean rate of 8 +/- 2 microg/kg/min of dopamine raised SAP from 30 +/- 3 to 41 +/- 5 mm Hg (P < .05), and the pulmonary artery pressures from 25 +/- 5 to 32 +/- 8 mm Hg (P < .05). The SVC flow increased by 30% (from 130 +/- 40 to 170 +/- 44 mL/kg/min; P < .05). The left ventricular output and the end-diastolic and mean left pulmonary artery blood flow velocities did not change despite the increase in pulmonary artery pressure.
In preterm infants with hypotension and PDA, dopamine (<10 microg/kg/min) increases the systemic blood pressure and the systemic blood flow. Our results suggest that dopamine decreases left-to-right shunting across ductus arteriosus, caused by a rise in pulmonary vascular resistances.
研究多巴胺对患有低血压和动脉导管未闭（PDA）的早产儿的体循环动脉压（SAP）和体循环血流量（SBF）（用上腔静脉[SVC]血流估算）的影响。
对胎龄<32周、患有PDA和体循环低血压的早产儿，在开始使用多巴胺前及用药2小时后测量临床和超声心动图变量。
纳入17例早产儿（胎龄28±2周；出生体重1030±400g）。多巴胺平均输注速率为8±2μg/kg/min时，SAP从30±3mmHg升至41±5mmHg（P<.05），肺动脉压从25±5mmHg升至32±8mmHg（P<.05）。SVC血流增加30%（从130±40增至170±44mL/kg/min；P<.05）。尽管肺动脉压升高，但左心室输出量以及舒张末期和平均左肺动脉血流速度未改变。
在患有低血压和PDA的早产儿中，多巴胺（<10μg/kg/min）可升高体循环血压和体循环血流量。我们的结果表明，多巴胺可减少因肺血管阻力升高导致的动脉导管水平的左向右分流。
