Comparison of the haemodynamic effects of dopamine and dobutamine in young children undergoing cardiac surgery.
Nineteen children, aged 2-54 months, requiring high-dose inotropic support after cardiac surgery, were given either dopamine or dobutamine in a blinded, double crossover, study. Using a pulmonary artery thermistor, right and left atrial cannulae, and pulmonary and femoral arterial catheters, conventional haemodynamic variables were measured hourly over three consecutive 4 h dopamine-dobutamine-dopamine or dobutamine-dopamine-dobutamine exchanges. No significant differences in haemodynamics occurred during dopamine therapy compared with the same dose of dobutamine in 14 patients receiving phenoxybenzamine 2 mg kg-1, four of whom had also received enoximone. In five patients, neither enoximone nor phenoxybenzamine was used and significant increases in pulmonary artery pressure and pulmonary vascular resistance (P = 0.04) occurred when patients were given dopamine rather than dobutamine. We conclude that dobutamine and dopamine are equipotent inotropes in children and that dopamine in doses > 7 micrograms kg-1 min-1, caused pulmonary vasoconstriction, an effect mediated by alpha adrenergic receptors.
Booker
P D
PD
Royal Liverpool Children's NHS Trust.
Evans
C
C
Franks
R
R
D006348:Cardiac Surgical Procedures; D002675:Child, Preschool; D018592:Cross-Over Studies; D004280:Dobutamine / Q000494:pharmacology*; D004298:Dopamine / Q000494:pharmacology*; D004311:Double-Blind Method; D017335:Enoximone / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007223:Infant; D010643:Phenoxybenzamine / Q000494:pharmacology; D013997:Time Factors
D010643:Phenoxybenzamine; D004280:Dobutamine; D017335:Enoximone; D004298:Dopamine