Perez C A, Reimer J M, Schreiber M D, Warburton D, Gregory G A
Crit Care Med. 1986 Dec;14(12):1045-9. doi: 10.1097/00003246-198612000-00010.
To achieve adequate arterial BP, adequate capillary filling time, and adequate peripheral pulses, hypotensive newborn infants often require higher doses of dopamine that reportedly reduce urine output in adults. Whether these larger doses of dopamine also reduce urine output in newborns is not known. Therefore, we determined the effects of administering high-dose dopamine (more than 20 micrograms/kg X min) on the urine output of 15 newborn infants. Five infants were studied prospectively and ten retrospectively. In the prospective study, urine output was determined as the dose of dopamine was increased; in the retrospective study, urine output was determined as the infants were being weaned from high doses of dopamine. Both data sets demonstrate that administering high-dosage dopamine does not reduce the urine output of sick newborn infants. Therefore, we conclude that doses of dopamine previously reported to decrease urine output in adults do not do so in sick newborn infants. Consequently, when necessary, high doses of dopamine may be used in sick newborn infants to achieve cardiovascular stability without reducing urine output.
为了达到足够的动脉血压、充足的毛细血管充盈时间和良好的外周脉搏，低血压的新生儿通常需要更高剂量的多巴胺，据报道，这种剂量的多巴胺会减少成人的尿量。而这些较大剂量的多巴胺是否也会减少新生儿的尿量尚不清楚。因此，我们测定了给予大剂量多巴胺（超过20微克/千克×分钟）对15例新生儿尿量的影响。其中5例婴儿进行了前瞻性研究，10例进行了回顾性研究。在前瞻性研究中，随着多巴胺剂量的增加测定尿量；在回顾性研究中，在婴儿从高剂量多巴胺撤药时测定尿量。两个数据集均表明，给予高剂量多巴胺不会减少患病新生儿的尿量。因此，我们得出结论，先前报道的可减少成人尿量的多巴胺剂量对患病新生儿并无此作用。因此，必要时，可在患病新生儿中使用高剂量多巴胺以实现心血管稳定，而不减少尿量。
