title: Observational study of cerebral hemodynamics during dopamine treatment in hypotensive ELBW infants on the first day of life.
abstract: OBJECTIVE
  To evaluate cerebral hemodynamics during dopamine treatment in hypotensive (mean arterial blood pressure (MABP)<gestational age) extremely low birth weight (ELBW) infants.
  
  
  METHODS
  Continuous monitoring of cerebral blood flow velocity (CBFv), MABP and PCO2 was performed in hypotensive ELBW infants on the first day of life, beginning with an ∼15-min baseline reading and continued during advancing dopamine infusion until MABP was optimized. Physiological variables and CBFv reactivity were compared before and after MABP was optimized.
  
  
  RESULTS
  Fifteen hypotensive ELBW infants (625±174 g; 24 (23 to 24.8) weeks) were studied. Mean CBFv increased from 10.9±3.7 to 15.7±5.7 cm s(-1) (P=0.001) simultaneously as MABP increased from 22.3±2.8 to 35.2±9.7 mm Hg (P<0.001). Mean CBFv reactivity (95% confidence interval (CI)) was 3.9 (1.6 to 6.2) %mm Hg(-1). Nine infants died and/or developed severe intraventricular hemorrhage (IVH).
  
  
  CONCLUSIONS
  Mean CBFv increased pressure-passively as MABP was optimized by dopamine treatment in very sick hypotensive ELBW infants on the first day of life.
authors.affiliation: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Lightburn
authors.forename: C H
authors.initials: CH
authors.lastname: Gauss
authors.forename: D K
authors.initials: DK
authors.lastname: Williams
authors.forename: J R
authors.initials: JR
authors.lastname: Kaiser
mesh_terms: D001783:Blood Flow Velocity; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004298:Dopamine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000503:physiopathology*; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies
chemical_list: D002316:Cardiotonic Agents; D004298:Dopamine