Current usage of dopamine in New Zealand intensive care units.
A nation-wide evaluation of dopamine usage in New Zealand Intensive Care Units (ICUs) was undertaken. Twenty-six public hospital ICUs participated. Twenty-two ICUs (85%) use dopamine as an inotrope. Seventeen ICUs use dopamine for presumed selective renal effects at least occasionally, but with wide variation in what is considered to be "renal-dose". Level 3 ICUs were less likely to use "renal-dose" dopamine than levels 1 and 2 (P= 0.01). Nineteen units (83%) use weight-referenced (i.e., microg x kg(-1) x min(-1)) dopamine administration. Weight-referenced administration and "renal-dose" dopamine were likely to be in use together (P=0.02). Standard dopamine dilutions varied widely with a median of 2 mg x ml(-1) (range 0.4 to 8 mg x ml(-1)). Given a demonstrated association between weight-referenced administration and "renal-dose" dopamine, along with particular pharmacokinetic and pharmacodynamic reservations, the value of weight-referenced administration of dopamine in adult patients is questioned.
McHugh
G J
GJ
Department of Anaesthesia and Intensive Care, Palmerston North Hospital, New Zealand.
D001835:Body Weight; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004298:Dopamine / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D017723:Drug Utilization Review; D006801:Humans; D007362:Intensive Care Units / Q000145:classification / Q000706:statistics & numerical data*; D007668:Kidney / Q000187:drug effects; D009520:New Zealand; D012015:Reference Standards
D002316:Cardiotonic Agents; D004298:Dopamine