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Cardiovascular responses to dobutamine determined by systolic time intervals in preterm infants
H Stopfkuchen1, A Queisser-Luft, K Vogel
1Universitätskinderklinik, Mainz, FRG.
Insights
Dobutamine therapy significantly improved myocardial function in premature infants with depressed cardiac performance. This treatment enhanced left ventricular performance, as indicated by key systolic time intervals.
Area of Science:
- Neonatal Cardiology
- Pediatric Pharmacology
Background:
- Premature infants often experience hemodynamic instability.
- Assessing myocardial function in this population is crucial for effective treatment.
Purpose of the Study:
- To evaluate the impact of dobutamine on left ventricular performance in premature infants.
- To determine if dobutamine improves cardiac function in hemodynamically unstable neonates.
Main Methods:
- Echocardiography was used to measure left ventricular systolic time intervals.
- Rate-corrected pre-ejection period (PEPI), rate-corrected left ventricular ejection time (LVETI), and PEP/LVET ratio were assessed.
- Measurements were taken before and after dobutamine infusion (10 µg/kg/min) in 17 infants.
Main Results:
- Dobutamine significantly decreased PEPI and the PEP/LVET ratio.
- A significant increase in LVETI was observed post-dobutamine.
- Heart rate and mean arterial pressure also showed significant increases.
Conclusions:
- Dobutamine therapy effectively enhances left ventricular performance in premature infants with compromised cardiac function.
- The study demonstrates dobutamine's utility in managing myocardial dysfunction in neonates.
Abstract:
We investigated the effects of dobutamine therapy on myocardial function in premature infants. Left ventricular performance was assessed by measuring left ventricular systolic time intervals: rate-corrected pre-ejection period (PEPI), rate-corrected left ventricular ejection time (LVETI), and pre-ejection period to left ventricular ejection time ratio (PEP/LVET) which was obtained by echocardiography. Measurements were performed in 17 hemodynamically unstable premature infants who had an elevated PEP/LVET ratio before and 30 min after starting dobutamine infusion (10 micrograms/kg.min). Dobutamine infusion resulted in a significant decrease in PEPI (from 108 +/- 16 [SEM] to 95 +/- 17 msec; p less than .01) and in PEP/LVET ratio (from 0.55 +/- 0.16 [SEM] to 0.45 +/- 0.17; p less than .01), and in a significant increase in LVETI (from 255 +/- 15.7 [SEM] to 264 +/- 16.2 msec; p less than .01). Heart rate increased significantly from 146 +/- 17 (SEM) to 163 +/- 16 beat/min; p less than .01. Mean arterial pressure increased in 12 of 14 infants. These results show that dobutamine enhances left ventricular performance in premature infants who have depressed left ventricular function.