Dobutamine: a hemodynamic evaluation in children with shock.

The hemodynamic effects of dobutamine were studied in 33 infants and children with cardiogenic or septic shock. Dobutamine was administered at doses of 2.5, 5.0, 7.5, and 10.0 micrograms/kg/minute. Significant increases above preinfusion values were observed in cardiac index, left ventricular stroke work index, and pulmonary wedge pressure. Significant decreases from preinfusion values were observed in systemic arteriolar resistance index. No significant differences occurred in heart rate, mean systemic arterial pressure, mean pulmonary arterial pressure, right atrial pressure, or pulmonary arteriolar resistance index. Analysis of the data also revealed significant effects of age and diagnosis on the hemodynamic responses. These data suggest that dobutamine is a useful drug in the pharmacologic management of children in shock, especially in children older than 12 months with cardiogenic shock not complicated by severe hypotension.