Joynt Chloe, Cheung Po-Yin
Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
Department of Pharmacology, University of Alberta, Edmonton, AB, Canada.
Front Pediatr. 2018 Dec 10;6:363. doi: 10.3389/fped.2018.00363. eCollection 2018.
Asphyxiated neonates often have hypotension, shock, and poor tissue perfusion. Various "inotropic" medications are used to provide cardiovascular support to improve the blood pressure and to treat shock. However, there is incomplete literature on the examination of hemodynamic effects of these medications in asphyxiated neonates, especially in the realm of clinical studies (mostly in late preterm or term populations). Although the extrapolation of findings from animal studies and other clinical populations such as children and adults require caution, it seems appropriate that findings from carefully conducted pre-clinical studies are important in answering some of the fundamental knowledge gaps. Based on a literature search, this review discusses the current available information, from both clinical studies and animal models of neonatal asphyxia, on common medications used to provide hemodynamic support including dopamine, dobutamine, epinephrine, milrinone, norepinephrine, vasopressin, levosimendan, and hydrocortisone.
窒息新生儿常出现低血压、休克及组织灌注不良。各种“强心”药物用于提供心血管支持，以提高血压并治疗休克。然而，关于这些药物对窒息新生儿血流动力学影响的研究文献并不完整，尤其是在临床研究领域（大多针对晚期早产儿或足月儿）。尽管从动物研究及儿童和成人等其他临床群体的研究结果进行推断时需谨慎，但精心开展的临床前研究结果对于填补一些基础知识空白似乎很重要。基于文献检索，本综述讨论了来自新生儿窒息临床研究和动物模型的当前可用信息，这些信息涉及用于提供血流动力学支持的常用药物，包括多巴胺、多巴酚丁胺、肾上腺素、米力农、去甲肾上腺素、血管加压素、左西孟旦和氢化可的松。
