Dobutamine infusions in stable, critically ill children

Berg, Robert A.; Donnerstein, Richard L.; Padbury, Jamés F.

doi:10.1097/00003246-199305000-00010

Cited by 59 publications

(35 citation statements)

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“…Five of the studies found that as the infusion dose of dobutamine increased, so did the serum concentration of dobutamine [4,6,7,24,39]. Three of the studies reported significant strengths with regard to this association (r = 0.95, 0.94 and 0.97 p = \0.05) [6,7,24].…”

Section: Infusion Rate Relationship With Plasma Dobutamine Serum Concmentioning

confidence: 97%

“…Three of the studies reported significant strengths with regard to this association (r = 0.95, 0.94 and 0.97 p = \0.05) [6,7,24]. Such a relationship was also noted in neonates with dobutamine infusion doses of 2.5, 5 and 7.5 mcg/kg/min each leading to mean serum concentrations of dobutamine of 21, 39 and 68 ng/ml [39].…”

Section: Infusion Rate Relationship With Plasma Dobutamine Serum Concmentioning

confidence: 97%

“…Three studies in neonates reported a 21 % (37 ml/kg/min) increase in cardiac output in response to dobutamine infusions up to 10 mcg/kg/min [15,39,55]. The mean dosage for a change in cardiac output or index detected was between 1.0 and 2.7 mcg/kg/min (threshold range 0.2-9 mcg/kg/min) [6,24,39].…”

Section: Stroke Volume Cardiac Output and Indexmentioning

confidence: 99%

“…The average clearance rate reported across five studies was 94.2 ml/kg/min [5][6][7]24]. Wide ranges of dobutamine clearance were also reported [5,7,24] with one study reporting clearance rates of 12.5-1399 ml/kg/min [62].…”

Section: Clearance Of Dobutaminementioning

confidence: 99%

“…Four studies concluded that the dobutamine clearance did not vary with infusion rate and therefore exhibited firstorder kinetics [6,7,24,39]. However, Banner et al [4] found a significantly negative dobutamine correlation between dobutamine clearance and infusion rates (p \ 0.001).…”

Section: Clearance Of Dobutaminementioning

confidence: 99%

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A Literature Review of the Pharmacokinetics and Pharmacodynamics of Dobutamine in Neonates

et al. 2015

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Since its discovery in 1975 dobutamine has been used off-label for treating hemodynamic insufficiency in newborns and children. We present a structured literature review of pharmacokinetic and pharmacodynamic data for dobutamine in the pediatric population. Structured searches were conducted to identify relevant articles according to pre-defined inclusion criteria. Where possible, results for the pharmacodynamic and pharmacokinetic effect of dobutamine were reported as pooled data. Forty-six papers met the inclusion criteria. With regard to pharmacodynamic data a number of studies reported significant increases in a number of clinical parameters such as heart rate, blood pressure, cardiac output across a wide range of pediatric populations. With regard to pharmacokinetic data studies reported that the infusion rate was positively correlated to plasma dobutamine concentration. There was great variability with regard to dobutamine clearance between individuals and as to whether it followed first- or zero-order elimination kinetics. While the pharmacodynamic effects of dobutamine appear to reflect the pharmacological profile of the drug, the pharmacokinetic data are difficult to interpret due to inhomogeneity between study populations ages, comorbidities, dobutamine dosages and methodologies. High-quality prospective pharmacokinetic and pharmacodynamic data especially in newborns are urgently required prior to a large randomized study.

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