Bhatt-Mehta V, Nahata M C, McClead R E, Menke J A
College of Pharmacy, Ohio State University, Columbus.
Eur J Clin Pharmacol. 1991;40(6):593-7. doi: 10.1007/BF00279976.
Dopamine is frequently used in critically ill newborn infants for treatment of shock and cardiac failure, but its pharmacokinetics has not been evaluated using a specific analytical method. Steady-state arterial plasma concentrations of dopamine were measured in 11 seriously ill infants receiving dopamine infusion, 5-20 micrograms.kg-1.min-1, for presumed or proven sepsis and hypotensive shock. Steady-state concentrations of dopamine ranged from 0.013-0.3 microgram/ml. Total body clearance averaged 115 ml.kg-1.min-1. The apparent volume of distribution and elimination half life averaged 1.8 l.kg-1 and 6.9 min, respectively. No relationship was observed between dopamine pharmacokinetics and gestational age, postnatal age or birthweight. Substantial interindividual variation was seen in dopamine pharmacokinetics in seriously ill infants, and plasma concentrations could not be predicted accurately from its infusion rate. Marked variation in clearance explains in part, the wide dose requirements of dopamine needed to elicit clinical response in critically ill newborn infants.
多巴胺常用于危重新生儿以治疗休克和心力衰竭，但其药代动力学尚未使用特定分析方法进行评估。对11名接受多巴胺输注（剂量为5 - 20微克·千克⁻¹·分钟⁻¹）的重症婴儿测定了多巴胺的稳态动脉血浆浓度，这些婴儿因疑似或确诊败血症及低血压休克而接受治疗。多巴胺的稳态浓度范围为0.013 - 0.3微克/毫升。总体清除率平均为115毫升·千克⁻¹·分钟⁻¹。表观分布容积和消除半衰期平均分别为1.8升·千克⁻¹和6.9分钟。未观察到多巴胺药代动力学与胎龄、出生后年龄或出生体重之间存在关联。在重症婴儿中，多巴胺药代动力学存在显著的个体间差异，且无法根据其输注速率准确预测血浆浓度。清除率的显著差异部分解释了危重新生儿引发临床反应所需多巴胺剂量需求广泛的原因。
