血浆蛋白部分与多巴胺用于低血压极低出生体重儿的随机对照试验
Randomised controlled trial of plasma protein fraction versus dopamine in hypotensive very low birthweight infants.
作者信息
Gill A B, Weindling A M
机构信息
Neonatal Intensive Care Unit, Liverpool Maternity Hospital.
出版信息
Arch Dis Child. 1993 Sep;69(3 Spec No):284-7. doi: 10.1136/adc.69.3_spec_no.284.
Abstract
Around 20% of very low birthweight infants admitted to a neonatal intensive care unit become hypotensive within 24 hours of their admission. Standard treatment is either expansion of the circulating volume by the infusion of plasma protein fraction or by using dopamine to improve cardiac function. The purpose of this study was to investigate by a randomised controlled trial which was the most appropriate treatment. Thirty nine infants were randomised to receive either plasma protein fraction or dopamine as first line treatment if they became hypotensive within 24 hours of admission to the neonatal intensive care unit. Seventeen of 19 (89%) infants responded to dopamine, whereas only 9/20 (45%) responded to plasma protein fraction. The median dose of dopamine needed to increase the blood pressure to at least the 10th centile was 7.5 micrograms/kg/min and was infused for a median duration of 18 hours. These observations suggest that dopamine should be used earlier in the treatment of these infants than has previously been recommended.
摘要
入住新生儿重症监护病房的超低出生体重儿中，约20%在入院24小时内会出现低血压。标准治疗方法要么是输注血浆蛋白组分来扩充循环血容量，要么使用多巴胺来改善心脏功能。本研究的目的是通过一项随机对照试验来调查哪种治疗方法最为合适。39名婴儿在入住新生儿重症监护病房24小时内出现低血压时，被随机分配接受血浆蛋白组分或多巴胺作为一线治疗。19名婴儿中有17名（89%）对多巴胺有反应，而只有9/20（45%）对血浆蛋白组分有反应。将血压提高到至少第10百分位数所需的多巴胺中位剂量为7.5微克/千克/分钟，输注的中位持续时间为18小时。这些观察结果表明，在治疗这些婴儿时，多巴胺应比先前推荐的时间更早使用。
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