title: Effect of dopamine on peripheral perfusion in very-low-birth-weight infants during the transitional period.
abstract: BACKGROUND
  Dopamine is one of the most frequently used inotropic drugs in neonatal intensive care units (NICUs); however, it does not seem to improve outcomes in premature infants. Given that the ultimate aim of cardiovascular management is to stabilize and maintain organ perfusion, an understanding of dopamine's effects on organ blood flow will help in judging when to use dopamine and how to titrate the dosage. Such an approach can lead to improved outcomes. This study aimed to evaluate the effects of dopamine on peripheral perfusion in very-low-birth-weight (VLBW) infants within 72 h of birth.
  
  
  METHODS
  This prospective observational study identified and sampled 44 instances of initiation of dopamine treatment or increase in dopamine dose in 29 VLBW infants. Blood pressure, heart rate, and skin and subcutaneous blood flow were measured and compared before and after each instance.
  
  
  RESULTS
  Blood pressure and skin and subcutaneous blood flow in the lower limbs increased after initiation of dopamine treatment or after dose increase.
  
  
  CONCLUSIONS
  Dopamine increases blood pressure as well as skin and subcutaneous blood flow in VLBW infants despite its supposed vasoconstrictive action, indicating that it increases both perfusion pressure and blood flow and is devoid of overwhelming peripheral vasoconstrictive effects.
authors.affiliation: Division of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan. akio-i@k4.dion.ne.jp
authors.forename: Akio
authors.initials: A
authors.lastname: Ishiguro
authors.forename: Keiji
authors.initials: K
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Sekine
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kawasaki
authors.forename: Kanako
authors.initials: K
authors.lastname: Itoh
authors.forename: Masayo
authors.initials: M
authors.lastname: Kanai
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ezaki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kunikata
authors.forename: Hisanori
authors.initials: H
authors.lastname: Sobajima
authors.forename: Masanori
authors.initials: M
authors.lastname: Tamura
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D004298:Dopamine / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007866:Leg / Q000098:blood supply*; D008297:Male; D019370:Observation; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000187:drug effects*; D012867:Skin / Q000098:blood supply*
chemical_list: D004298:Dopamine