Cardiopulmonary response to dopamine in chronically catheterized neonatal lambs.

Seven neonatal lambs were chronically catheterized. An electromagnetic flow probe was placed around the main pulmonary artery, and the ductus arteriosus ligated. After recovery, dopamine's effect was tested at 10 doses over the range 1--400 micrograms/kg/min in 12 studies, at ages 3 to 16 days. Pulmonary vascular resistance (PVR) increased from 0.093 +/- 0.01 to 0.14 +/- 0.02 mm Hg/ml/kg/min at the highest dose. Systemic vascular resistance (SVR) was unchanged at doses less than 20 micrograms/kg/min, but increased 99% from 0.38 +/- 0.04 to 0.79 +/- 0.08 mm Hg/ml/kg/min (P less than 0.005) at 200--400 micrograms/kg/min. The ratio PVR/SVR increased 18% from 0.26 +/- 0.32 to 0.32 +/- 0.05 at a dose of 17--20 mg/kg/min, then declined to 0.19 +/- 0.03 at 200--400 microgram/kg/min (P less than 0.05). Pulmonary blood flow was unchanged. Left atrial pressure increased sharply at doses above 50 micrograms/kg/min (P less than 0.005). Transient bradyarrhythmia occurred in 9 of 12 studies at infusion rates of 50--200 micrograms/kg/min. Heart rate did not change until recovery when it increased (48%) from 181 to 292 (P less than 0.005). These data suggest that the dopamine response in the intact neonate is complex with divergent and dose-dependent effects on the pulmonary and systemic circuit.