title: Fenoldopam in newborn patients undergoing cardiopulmonary bypass: controlled clinical trial.
abstract: We determined if low dose fenoldopam in neonates already receiving conventional diuretics improves urine output, fluid balance, acute kidney injury incidence (AKI) and time to extubation. A prospective controlled clinical trial in a pediatric cardiac intensive care unit on 40 neonates undergoing cardiac surgery with cardiopulmonary bypass, excluding simple ventricular septal defect and atrial septal defect. Fenoldopam was infused at a low dose of 0.1 microg/kg/min soon after anesthesia induction and infusion prolonged for 72 h in 20 patients. Twenty neonates with standardized perioperative therapy except fenoldopam administration served as controls. Demographic, hemodynamic, daily urine output, creatinine, creatinine clearance, serum and urinary sodium and potassium were recorded. Inotropic score (IS) was calculated as a surrogate for the degree of hemodynamic impairment. Low dose fenoldopam infusion did not show beneficial effects in renal function. The treatment did not significantly affect IS value, AKI incidence, fluid balance control, time to sternal closure, time to extubation and time to intensive care unit discharge. Low dose fenoldopam in neonates undergoing cardiac surgery with CPB did not produce effects on urine output, fluid balance and AKI incidence. Fenoldopam was well tolerated and did not negatively affect hemodynamics and vasopressor support.
authors.affiliation: Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Hospital, Rome, Italy. zaccaria.ricci@fastwebnet.it
authors.forename: Zaccaria
authors.initials: Z
authors.lastname: Ricci
authors.forename: Giulia V
authors.initials: GV
authors.lastname: Stazi
authors.forename: Luca
authors.initials: L
authors.lastname: Di Chiara
authors.forename: Stefano
authors.initials: S
authors.lastname: Morelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Vitale
authors.forename: Chiara
authors.initials: C
authors.lastname: Giorni
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.forename: Sergio
authors.initials: S
authors.lastname: Picardo
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D018491:Dopamine Agonists / Q000008:administration & dosage*; D018818:Fenoldopam / Q000008:administration & dosage*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007263:Infusions, Parenteral; D007674:Kidney Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D010351:Patient Discharge; D011188:Potassium / Q000097:blood / Q000652:urine; D011446:Prospective Studies; D012121:Respiration, Artificial; D012964:Sodium / Q000097:blood / Q000652:urine; D013249:Sternum / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014554:Urination / Q000187:drug effects*; D014563:Urodynamics / Q000187:drug effects*; D014882:Water-Electrolyte Balance / Q000187:drug effects
chemical_list: D018491:Dopamine Agonists; D012964:Sodium; D003404:Creatinine; D018818:Fenoldopam; D011188:Potassium