Stowe C D, Storgion S A, Lee K R, Phelps S J
Department of Clinical Pharmacy, University of Tennessee, Memphis 38163, USA.
Pharmacotherapy. 1996 Nov-Dec;16(6):1018-23.
To evaluate the effect of an intentional alteration in infusion pump flow continuity on the hemodynamic stability of infants receiving either dobutamine or dopamine.
Prospective, open-label study.
A university-affiliated children's hospital.
Ten hemodynamically stable infants (age 2 wks-10 mo) in intensive care receiving dobutamine (5) or dopamine (5). Three patients received both agents and were studied at independent times.
Dobutamine and dopamine were administered using the Flo-Gard VP pump that delivers an intentional alteration of flow continuity (rate pulse). Heart rate and mean arterial pressure (MAP) were recorded every second. Analysis was based on the measurements obtained from the first 5 minutes on the study pump and the 2 minutes before and after the rate pulse.
Although hemodynamic changes in pre- and post-rate pulses were statistically significant (p < 0.05) in some individuals, only one infant had a greater that 10% change in MAP 2 minutes after the rate pulse. Alterations in hemodynamics were not consistent among or within patients.
In infants requiring dobutamine or dopamine, no clinically significant pharmacodynamic effects were associated with alteration in continuity of drug delivery caused by the single positive rate pulse. Therefore, we conclude there is no contraindication to the use of this infusion pump in hemodynamically stable infants receiving these drugs.
评估输液泵流速连续性的有意改变对接受多巴酚丁胺或多巴胺治疗的婴儿血流动力学稳定性的影响。
前瞻性、开放标签研究。
一所大学附属医院的儿童医院。
10名在重症监护室接受多巴酚丁胺（5例）或多巴胺（5例）治疗的血流动力学稳定的婴儿（年龄2周 - 10个月）。3名患者接受了两种药物治疗，并在不同时间进行研究。
使用Flo - Gard VP泵给予多巴酚丁胺和多巴胺，该泵会有意改变流速连续性（速率脉冲）。每秒记录心率和平均动脉压（MAP）。分析基于在研究泵上最初5分钟以及速率脉冲前后2分钟获得的测量值。
尽管在某些个体中速率脉冲前后的血流动力学变化具有统计学意义（p < 0.05），但只有一名婴儿在速率脉冲后2分钟时MAP变化超过10%。血流动力学改变在患者之间和患者内部并不一致。
在需要多巴酚丁胺或多巴胺的婴儿中，单次正向速率脉冲引起的药物输送连续性改变未产生临床上显著的药效学效应。因此，我们得出结论：对于接受这些药物治疗的血流动力学稳定的婴儿，使用这种输液泵没有禁忌证。
