Hemodynamic response to intentionally altered flow continuity of dobutamine and dopamine by an infusion pump in infants.
OBJECTIVE
To evaluate the effect of an intentional alteration in infusion pump flow continuity on the hemodynamic stability of infants receiving either dobutamine or dopamine.


METHODS
Prospective, open-label study.


METHODS
A university-affiliated children's hospital.


METHODS
Ten hemodynamically stable infants (age 2 wks-10 mo) in intensive care receiving dobutamine (5) or dopamine (5). Three patients received both agents and were studied at independent times.


METHODS
Dobutamine and dopamine were administered using the Flo-Gard VP pump that delivers an intentional alteration of flow continuity (rate pulse). Heart rate and mean arterial pressure (MAP) were recorded every second. Analysis was based on the measurements obtained from the first 5 minutes on the study pump and the 2 minutes before and after the rate pulse.


RESULTS
Although hemodynamic changes in pre- and post-rate pulses were statistically significant (p < 0.05) in some individuals, only one infant had a greater that 10% change in MAP 2 minutes after the rate pulse. Alterations in hemodynamics were not consistent among or within patients.


CONCLUSIONS
In infants requiring dobutamine or dopamine, no clinically significant pharmacodynamic effects were associated with alteration in continuity of drug delivery caused by the single positive rate pulse. Therefore, we conclude there is no contraindication to the use of this infusion pump in hemodynamically stable infants receiving these drugs.
Stowe
C D
CD
Department of Clinical Pharmacy, University of Tennessee, Memphis 38163, USA.
Storgion
S A
SA
Lee
K R
KR
Phelps
S J
SJ
D002316:Cardiotonic Agents / Q000008:administration & dosage*; D004280:Dobutamine / Q000008:administration & dosage*; D004298:Dopamine / Q000008:administration & dosage*; D006330:Heart Defects, Congenital / Q000188:drug therapy; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D012128:Respiratory Distress Syndrome / Q000188:drug therapy
D002316:Cardiotonic Agents; D004280:Dobutamine; D004298:Dopamine