IMPACT ON BLOOD-PRESSURE AND INTESTINAL PERFUSION OF DOBUTAMINE OR DOPAMINE IN HYPOTENSIVE PRETERM INFANTS

In a prospective study hemodynamic effects of dobutamine or dopamine ( 10 mu g/kg/min) were investigated in 20 preterm infants who had protra cted arterial hypotension refractory to volume therapy. Doppler ultras onography of the superior mesenteric artery (SMA) was applied to verif y intestinal perfusion and blood pressure was recorded in parallel. Me an arterial pressure (MAP) raised significantly in both groups (from 3 1.0 +/- 6.8 to 37.7 +/- 9.8 mm Hg during dobutamine and from 27.7 +/- 3.6 to 36.0 +/- 9.3 mm Hg during dopamine). Mean blood flow velocity i ncreased from 25.8 +/- 13.5 to 31.5 +/- 16.5 cm/s with dobutamine and from 16.3 +/- 5.0 to 19.0 +/- 6.0 cm/s with dopamine (significant for dobutamine). Vascular resistance of SMA (indicated by resistance index ; RI) decreased from 0.81 +/- 0.07 to 0.74 +/- 0.11 for dobutamine and from 0.89 +/- 0.06 to 0.79 +/- 0.07 for dopamine (significant for bot h groups). These data indicate that in the dose tested here both catec holamines are equally effective in raising MAP and lead to a significa nt increase of intestinal perfusion. Thus, a negative impact on mesent eric blood supply, predisposing to necrotizing enterocolitis, is not p robable.