Effect of dopamine on peripheral perfusion in very-low-birth-weight infants during the transitional period

Ishiguro, Akio; Suzuki, Keiji; Sekine, Takashi; Kawasaki, Hidenori; Itoh, Kanako; Kanai, Masayo; Ezaki, Shoichi; Kunikata, Tetsuya; Sobajima, Hisanori; Tamura, Masanori

doi:10.1038/pr.2012.37

Cited by 13 publications

(11 citation statements)

References 24 publications

(30 reference statements)

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“…Concerns have been raised about the potential vasoconstrictive affects of dopamine (27). However, the results of our previous study (25) demonstrated that even if the dose was 10-20 μg/kg/ min, dopamine significantly increased LBF in VLBW infants. Cardiovascular adrenergic receptor downregulation might explain the decreased cardiovascular responsiveness to dopamine in critically ill preterm infants (28).…”

Section: Peripheral Hypoperfusion and Ivhmentioning

confidence: 89%

“…FBF was a less effective predictor of IVH than LBF. In our previous investigation on the hemodynamic effects of dopamine in VLBW infants (25), FBF was less informative than changes in LBF. No clear explanation for this finding exists at present; however, it may have been caused by differences in autonomic regulation between these two regions.…”

Section: Peripheral Hypoperfusion and Ivhmentioning

confidence: 99%

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Skin blood flow as a predictor of intraventricular hemorrhage in very-low-birth-weight infants

et al. 2013

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Background: Cardiovascular instability immediately after birth is associated with intraventricular hemorrhage (IVH) in very-low-birth-weight (VLBW) infants. For circulatory management, evaluation of organ blood flow is important. In this study, the relationship between peripheral perfusion within 48 h after birth and IVH was evaluated in VLBW infants. Methods: In this prospective observational study involving 83 VLBW infants, forehead blood flow (FBF) and lower-limb blood flow (LBF) were measured for 48 h after birth using a laser Doppler flowmeter. Blood flow was compared between infants with and without IVH. Multivariate logistic regression analysis was performed to identify the risk factors for IVH. results: IVH developed in nine infants. In eight of these patients, IVH occurred after 24 h. LBF was lower in infants with IVH at 18 and 24 h and increased to the same level as that of infants without IVH at 48 h. Multivariate logistic regression analysis identified a correlation only between LBF and IVH at 18 h. conclusion: These findings were consistent with the hypoperfusion-reperfusion theory, which states that IVH develops after reperfusion subsequent to hypoperfusion. We speculate that measurement of skin blood flow in addition to systemic and cerebral circulation may be helpful in predicting IVH.

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Section: Peripheral Hypoperfusion and Ivhmentioning

confidence: 89%

Section: Peripheral Hypoperfusion and Ivhmentioning

confidence: 99%

Skin blood flow as a predictor of intraventricular hemorrhage in very-low-birth-weight infants

et al. 2013

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“…However an observational study where dopamine was administered to hypotensive VLBW infants found that skin blood flow increased in parallel with blood pressure [31]. Dopamine has been shown to suppress pituitary function in preterm infants, resulting in decreased levels of thyroidstimulating hormone, thyroxin and prolactin, but extensive description of dopamine related endocrine effects is out of scope of the current literature review [14,[32][33][34][35].…”

Section: Dosingmentioning

confidence: 99%

Cardiovascular Drug Therapy for Human Newborn: Review of Pharmacodynamic Data

Ergenekon

Rojas-Anaya

Bravo

et al. 2018

CPD

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Background: Circulatory failure in preterm and term newborn infants is commonly treated with inotropes or vasoactive medications. In this structured literature review the available data on pharmacodynamic effects of the inotropes adrenaline, dobutamine, dopamine, levosimendan, milrinone, noradrenaline, and the vasoactive drugs vasopressin and hydrocortisone are presented. Methods: Structured searches were conducted to identify relevant articles according to pre-defined inclusion criteria which were human clinical trials published after 2000.Results: Out of 101 identified eligible studies only 22 studies met the criteria for evidence based practice guidelines level I to IV. The most prevalent pharmacodynamic effects were increase in blood pressure and/or heart rate, which were also the most frequently studied circulatory parameters. Conclusion: This review demonstrates the need for further systematic studies on all reviewed drugs with incorporation of novel noninvasive biomarkers in this vulnerable patient group, for more timely and appropriate treatment for clinical efficacy.

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“…A reduced response to infused catecholamines has been reported in preterm infants where many babies show limited response to dopamine or dobutamine administered to support cardiovascular function (Osborn et al 2002;Ishiguro et al 2012).…”

Section: Discussionmentioning

confidence: 99%

Endogenous angiotensins and catecholamines do not reduce skin blood flow or prevent hypotension in preterm piglets

et al. 2014

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Endocrine control of cardiovascular function is probably immature in the preterm infant; thus, it may contribute to the relative ineffectiveness of current adrenergic treatments for preterm cardiovascular compromise. This study aimed to determine the cardiovascular and hormonal responses to stress in the preterm piglet. Piglets were delivered by cesarean section either preterm (97 of 115 days) or at term (113 days). An additional group of preterm piglets received maternal glucocorticoids as used clinically. Piglets were sedated and underwent hypoxia (4% FiO2 for 20 min) to stimulate a cardiovascular response. Arterial blood pressure, skin blood flow, heart rate and plasma levels of epinephrine, norepinephrine, angiotensin II (Ang II), angiotensin‐(1–7) (Ang‐(1‐7)), and cortisol were measured. Term piglets responded to hypoxia with vasoconstriction; preterm piglets had a lesser response. Preterm piglets had lower blood pressures throughout, with a delayed blood pressure response to the hypoxic stress compared with term piglets. This immature response occurred despite similar high levels of circulating catecholamines, and higher levels of Ang II compared with term animals. Prenatal exposure to glucocorticoids increased the ratio of Ang‐(1‐7):Ang II. Preterm piglets, in contrast to term piglets, had no increase in cortisol levels in response to hypoxia. Preterm piglets have immature physiological responses to a hypoxic stress but no deficit of circulating catecholamines. Reduced vasoconstriction in preterm piglets could result from vasodilator actions of Ang II. In glucocorticoid exposed preterm piglets, further inhibition of vasoconstriction may occur because of an increased conversion of Ang II to Ang‐(1‐7).

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Effect of dopamine on peripheral perfusion in very-low-birth-weight infants during the transitional period

Cited by 13 publications

References 24 publications

Skin blood flow as a predictor of intraventricular hemorrhage in very-low-birth-weight infants

Skin blood flow as a predictor of intraventricular hemorrhage in very-low-birth-weight infants

Cardiovascular Drug Therapy for Human Newborn: Review of Pharmacodynamic Data

Endogenous angiotensins and catecholamines do not reduce skin blood flow or prevent hypotension in preterm piglets

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