Outwater K M, Treves S T, Lang P, Castaneda A R, Crone R K
Department of Pediatrics, Children's Hospital, Boston, MA.
J Clin Anesth. 1990 Jul-Aug;2(4):253-7. doi: 10.1016/0952-8180(90)90105-c.
The renal and hemodynamic effects of dopamine were measured during the immediate postoperative period in six infants following repair of congenital cardiac defects. Dopamine was infused at rates of 5, 10, and 15 micrograms/kg/min. Cardiac index (CI) increased significantly at a dopamine infusion rate of 15 micrograms/kg/min. The glomerular filtration rate (GFR) and urine output increased at dopamine infusion rates of 5 and 10 micrograms/kg/min and returned to baseline at 15 micrograms/kg/min. No significant changes occurred in right atrial pressure (RAP), left atrial pressure (LAP), systemic artery pressure, systemic vascular resistance (SVR), or pulmonary vascular resistance (PVR). Heart rate (HR) increased slightly at a dopamine infusion rate of 15 micrograms/kg/min. Pulmonary artery pressure (PAP) increased significantly in only one patient. These data demonstrate that infants require high doses of dopamine to produce the hemodynamic effects seen in adults and that these higher doses may be used without adverse renal effects.
在六名先天性心脏缺陷修复术后的婴儿术后即刻，测量了多巴胺的肾脏和血流动力学效应。多巴胺以5、10和15微克/千克/分钟的速率输注。当多巴胺输注速率为15微克/千克/分钟时，心脏指数（CI）显著增加。当多巴胺输注速率为5和10微克/千克/分钟时，肾小球滤过率（GFR）和尿量增加，而在15微克/千克/分钟时恢复至基线水平。右心房压力（RAP）、左心房压力（LAP）、体动脉压力、体循环血管阻力（SVR）或肺血管阻力（PVR）均未发生显著变化。当多巴胺输注速率为15微克/千克/分钟时，心率（HR）略有增加。仅一名患者的肺动脉压力（PAP）显著升高。这些数据表明，婴儿需要高剂量的多巴胺才能产生在成人中所见的血流动力学效应，并且这些较高剂量可在无不良肾脏影响的情况下使用。
