Abstract
This study evaluates the effects of graded DA infusions on hemodynamics and plasma epinephrine (E), norepinephrine (NE) and dopamine (DA). Five children with stable blood pressure but requiring inotropic support were studied. Two sets of baseline (BL) plasma CA and hemodynamic variables were obtained; patients then received dopamine infusions at 5, 10, 15 and 20 μg/kg/min for 20 minutes each. Data sets were obtained at the end of each infusion. Measured hemodynamic changes were compared to BL by analysis of variance and changes in CA concentrations were analyzed by linear regression. Results: Significant (p < 0.05) hemodynamic changes include: a decrease in mean arterial pressure at 5 μg/kg/min; increased right ventricular stroke work and O2 availability at 10 μg/kg/min; increase in cardiac index and left ventricular stroke work at 20 μg/kg/min. There were significant (p <0.01) linear correlations between DA infusion rate and plasma E (r = 0.68); NE (r = 0.84) and DA (r = 0.94). E and NE increased from mean BL concentration of 251 and 371 pg/ml to 753 and 679 pg/ml respectively at 20 μg/kg/min of DA. Conclusions: 1) DA infusions produce variable hemodynamic effects in patients emphasizing the need to individually titrate the infusion rate. 2) DA induced significant increases in plasma E as well as NE. This suggests that the hemodynamic action of DA may reflect increases in plasma E along with the previously recognized DA-induced NE release.
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Zaritsky, A., Pollack, M., Schaible, D. et al. DOPAMINE(DA) INFUSION: EFFECTS ON HEMODYNAMICS AND CATECHOLAMINE (CA) CONCENTRATIONS. Pediatr Res 18 (Suppl 4), 133 (1984). https://doi.org/10.1203/00006450-198404001-00243
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DOI: https://doi.org/10.1203/00006450-198404001-00243