Ferrara J J, Dyess D L, Peeples G L, Christenberry D P, Roberts W S, Tacchi E J, Swafford A N, Ardell J L, Powell R W
Department of Surgery, University of South Alabama College of Medicine, Mobile, USA.
Ann Surg. 1995 May;221(5):531-40; discussion 540-2. doi: 10.1097/00000658-199505000-00011.
The authors determined the effects of dopamine and dobutamine on organ blood flow in newborn piglets.
Although the hemodynamic effects of dopamine and dobutamine are well described in adults, little is known of their consequences in neonates, and their impact on organ perfusion in premature infants is unclear.
Cannulae were placed in the femoral vessels and left atrium of term (1-14 days old) and prematurely delivered (Ceasarean section at 90% of term gestation) piglets. After stabilization, radiolabeled microspheres were injected. A continuous infusion of dopamine or dobutamine was started, and other microspheres were injected at 5, 10, and 15-micrograms/kg/minute drug doses (allowing a 20-minute equilibration period at and between each dose). Blood flows (mL/minute/g tissue) to organs were determined using reference organ techniques.
In term animals only, dobutamine and dopamine increased systemic mean arterial pressure at the 15-micrograms dose. In term piglets, dobutamine produced dose-dependent increases (p < 0.05, analysis of variance) in heart and brain blood flow, although small intestinal blood flow decreased (1.47 +/- 0.13 mL/minute/g baseline to 1.31 +/- 0.11 mL/minute/g at 15-micrograms dose). There were no significant changes in blood flow to these organs in preterm animals. Dopamine significantly (p < 0.05) increased heart blood flow in both groups. Dopamine also increased small intestinal blood flow in term (1.63 +/- 0.22 mL/minute/g baseline to 3.13 +/- 0.34 mL/minute/g at 15-micrograms dose) and premature (0.31 +/- 0.10 mL/minute/g baseline to 1.11 +/- 0.29 at 15 micrograms dose) piglets.
Dopamine may prove a valuable adjunct when a premature infant is at risk for conditions that reduce alimentary tract blood flow.
作者们确定了多巴胺和多巴酚丁胺对新生仔猪器官血流的影响。
虽然多巴胺和多巴酚丁胺对成年人的血流动力学影响已有充分描述，但它们在新生儿中的后果却鲜为人知，且其对早产儿器官灌注的影响尚不清楚。
将套管插入足月（1 - 14日龄）和早产（妊娠90%时剖宫产）仔猪的股血管和左心房。稳定后，注入放射性标记的微球体。开始持续输注多巴胺或多巴酚丁胺，并在5、10和15微克/千克/分钟的药物剂量下注入其他微球体（每个剂量及剂量之间允许20分钟的平衡期）。使用参考器官技术测定器官的血流（毫升/分钟/克组织）。
仅在足月动物中，15微克剂量的多巴酚丁胺和多巴胺可增加体循环平均动脉压。在足月仔猪中，多巴酚丁胺使心脏和脑血流呈剂量依赖性增加（方差分析，p < 0.05），尽管小肠血流减少（基线时为1.47 ± 0.13毫升/分钟/克，15微克剂量时为1.31 ± 0.11毫升/分钟/克）。早产动物这些器官的血流无显著变化。多巴胺使两组动物的心脏血流均显著增加（p < 0.05）。多巴胺还使足月（基线时为1.63 ± 0.22毫升/分钟/克，15微克剂量时为3.13 ± 0.34毫升/分钟/克）和早产（基线时为0.31 ± 0.10毫升/分钟/克，15微克剂量时为1.11 ± 0.29毫升/分钟/克）仔猪的小肠血流增加。
当早产儿面临降低消化道血流的情况时，多巴胺可能是一种有价值的辅助药物。
