CIRCULATORY AND DIURETIC EFFECTS OF DOPEXAMINE INFUSION IN LOW-BIRTH-WEIGHT INFANTS WITH RESPIRATORY-FAILURE

Objective. To investigate the effects of infusion of dopexamine hydroc hloride, a new synthetic: catecholamine, on cardiopulmonary status and urine output in neonates with respiratory and circulatory failure. De sign. Prospective clinical study with each patient serving as his own control. Setting. Intensive care unit (14 beds) in a 300-bed paediatri c teaching: hospital. Patients. Seventeen neonates with low birth weig ht (LEW) requiring mechanical ventilation in the first 4 days of life, who initially had two of the following symptoms: hypotension, oliguri a, metabolic acidosis with base deficit > 10 and failure to respond to volume loading. lnterventions. Cardiopulmonary variables, diuresis an d acid-base status were measured before and after volume loading, in p atients who did not improve infusion of doper;amine was started at a d ose of 2 mu g kg(-1) min(-1) which was titrated to achieve blood press ure, urine output, and base deficit in normal range. Observations were continued for a period of 5 h. Measurements and results. Systolic blo od pressure increased significantly after 3 h. of dopexamine infusion and remained elevated up to the end of the study period. Diastolic and mean blood pressure increased slightly (NS). Diuresis increased signi ficantly from the 4th h of dopexamine infusion. Arterial blood pH incr eased significantly from baseline at 5 h after the start of dopexamine administration. There was also a significant imporovement in the PtcO (2)/PaO2 index. Conclusion. In neonates with respiratory and circulato ry failure, dopexamine increases blood pressure and improves arterial pH and urine output.