title: Dopamine therapy is associated with impaired cerebral autoregulation in preterm infants.
abstract: OBJECTIVE
  Hypotension is a common problem in newborn infants and is associated with increased mortality and morbidity. Dopamine is the most commonly used antihypotensive drug therapy, but has never been shown to improve neurological outcomes. This study tested our hypothesis that dopamine affects cerebral autoregulation (CA).
  
  
  METHODS
  Near-infrared spectroscopy was used to measure the cerebral oxygenation index in 60 very preterm infants, and mean arterial blood pressure was monitored towards the end of their first day of life. Measurements were performed continuously for two to three hour periods. CA was quantified as the cerebral oximetry index (COx).
  
  
  RESULTS
  We treated 13 of the 60 infants (22%) with dopamine during the measurements. COx was higher in the dopamine group than the untreated group (0.41 ± 0.25 vs. 0.08 ± 0.25, p < 0.001). Blood pressure tended to be lower in the dopamine group, but the anticipated difference in cerebral oxygenation was not detected. The need for mechanical ventilation in the first day of life and incidences of mortality was higher in the dopamine group.
  
  
  CONCLUSIONS
  Dopamine therapy was associated with decreased CA in preterm infants. We were unable to determine whether dopamine directly impaired CA or was merely an indicator of illness.
authors.affiliation: Department of Neonatology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
authors.forename: Vibeke R
authors.initials: VR
authors.lastname: Eriksen
authors.forename: Gitte H
authors.initials: GH
authors.lastname: Hahn
authors.forename: Gorm
authors.initials: G
authors.lastname: Greisen
mesh_terms: D062186:Arterial Pressure / Q000187:drug effects / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000187:drug effects* / Q000502:physiology; D004298:Dopamine / Q000627:therapeutic use*; D015259:Dopamine Agents / Q000627:therapeutic use*; D005260:Female; D006706:Homeostasis / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000503:physiopathology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D010092:Oximetry; D012189:Retrospective Studies; D019265:Spectroscopy, Near-Infrared
chemical_list: D015259:Dopamine Agents; D004298:Dopamine
keywords: Cerebral haemodynamics and oxygenation; Near-infrared spectroscopy; Newborn infants