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Right ventricular performance in hypotensive preterm neonates treated with dopamine
S J Clark1, C W Yoxall, N V Subhedar
1Neonatal Unit, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, United Kingdom. rvecho@yahoo.com
Pediatric Cardiology
|March 13, 2002
Summary
Dopamine therapy improves right ventricular function in preterm infants with respiratory distress syndrome by reducing end-systolic volume and increasing ejection fraction. This study highlights dopamine
Area of Science:
- Neonatal Cardiology
- Pediatric Critical Care
- Cardiovascular Physiology
Background:
- Systemic hypotension and left ventricular dysfunction are common in neonatal respiratory distress syndrome (RDS).
- Pulmonary hypertension is also prevalent in RDS, but the impact of inotropic agents on the right ventricle is not well understood.
Purpose of the Study:
- To evaluate the effects of inotropic therapy on right ventricular dimensions and function in hypotensive preterm infants with RDS.
- To assess changes in right ventricular performance following dopamine infusion.
Main Methods:
- Prospective study of hypotensive preterm neonates with RDS before and 1 hour after initiating dopamine infusion.
- Two-dimensional echocardiography with ellipsoid approximation was used to assess right ventricular dimensions and function.
Main Results:
- Dopamine significantly decreased right ventricular end-systolic volume (p < 0.01).
- Right ventricular ejection fraction significantly increased post-dopamine therapy (p < 0.01).
- A trend towards increased right ventricular output was observed (p=0.07).
Conclusions:
- Dopamine therapy enhances right ventricular ejection fraction in hypotensive preterm infants with RDS.
- The improvement in right ventricular function is primarily mediated by a reduction in end-systolic volume.