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Dopamine therapy is associated with impaired cerebral autoregulation in preterm infants
Author(s) -
Eriksen Vibeke R.,
Hahn Gitte H.,
Greisen Gorm
Publication year - 2014
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12817
Subject(s) - medicine , dopamine , cerebral autoregulation , autoregulation , pediatrics , intensive care medicine , neuroscience , blood pressure , biology
Aim Hypotension is a common problem in newborn infants and is associated with increased mortality and morbidity. Dopamine is the most commonly used antihypotensive drug therapy, but has never been shown to improve neurological outcomes. This study tested our hypothesis that dopamine affects cerebral autoregulation ( CA ). Methods Near‐infrared spectroscopy was used to measure the cerebral oxygenation index in 60 very preterm infants, and mean arterial blood pressure was monitored towards the end of their first day of life. Measurements were performed continuously for two to three hour periods. CA was quantified as the cerebral oximetry index ( CO x). Results We treated 13 of the 60 infants (22%) with dopamine during the measurements. CO x was higher in the dopamine group than the untreated group (0.41 ± 0.25 vs. 0.08 ± 0.25, p < 0.001). Blood pressure tended to be lower in the dopamine group, but the anticipated difference in cerebral oxygenation was not detected. The need for mechanical ventilation in the first day of life and incidences of mortality was higher in the dopamine group. Conclusion Dopamine therapy was associated with decreased CA in preterm infants. We were unable to determine whether dopamine directly impaired CA or was merely an indicator of illness.