Circulatory and diuretic effects of dopexamine infusion in low-birth-weight infants with respiratory failure.

OBJECTIVE

To investigate the effects of infusion of dopexamine hydrochloride, a new synthetic catecholamine, on cardiopulmonary status and urine output in neonates with respiratory and circulatory failure.

DESIGN

Prospective clinical study with each patient serving as his own control.

SETTING

Intensive care unit (14 beds) in a 300-bed paediatric teaching hospital.

PATIENTS

Seventeen neonates with low birth weight (LBW) requiring mechanical ventilation in the first 4 days of life, who initially had two of the following symptoms: hypotension, oliguria, metabolic acidosis with base deficit >10 and failure to respond to volume loading.

INTERVENTIONS

Cardiopulmonary variables, diuresis and acid-base status were measured before and after volume loading, in patients who did not improve infusion of dopexamine was started at a dose of 2 microg kg-1 min-1 which was titrated to achieve blood pressure, urine output, and base deficit in normal range. Observations were continued for a period of 5 h.

MEASUREMENTS AND RESULTS

Systolic blood pressure increased significantly after 3 h. of dopexamine infusion and remained elevated up to the end of the study period. Diastolic and mean blood pressure increased slightly (NS). Diuresis increased significantly from the 4th h of dopexamine infusion. Arterial blood pH increased significantly from baseline at 5 h after the start of dopexamine administration. There was also a significant improvement in the PtcO2/PaO2 index.

CONCLUSION

In neonates with respiratory and circulatory failure, dopexamine increases blood pressure and improves arterial pH and urine output.