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Association between dopamine and cerebral autoregulation in preterm neonates
Nina S Solanki1, Suma B Hoffman2
1Department of Pediatrics, School of Medicine, University of Maryland Baltimore, Baltimore, MD, USA.
Pediatric Research
|February 1, 2020
Summary
Dopamine administration in premature infants is linked to impaired cerebral autoregulation (ICA). ICA duration increased with higher dopamine doses, peaking between 11-15 μg/kg/min.
Area of Science:
- Neonatal physiology
- Neurocritical care
Background:
- Premature infants (<29 weeks gestation) are vulnerable to brain injury.
- Cerebral autoregulation (CA) maintains stable cerebral blood flow.
- Impaired cerebral autoregulation (ICA) is associated with adverse neurological outcomes.
Purpose of the Study:
- To investigate the association between dopamine and impaired cerebral autoregulation (ICA) in preterm infants.
- To determine if this association is dose-dependent.
Main Methods:
- Secondary analysis of prospectively enrolled preterm infants (<29 weeks gestation) within 12 hours of life.
- Continuous monitoring of cerebral oxygen saturation (rScO2) and mean arterial blood pressure (MAP) for 96 hours.
- ICA defined as an rScO2-MAP correlation coefficient >0.5 over 10-minute epochs.
Main Results:
- 38% of infants (23/61) received dopamine.
- Dopamine-exposed infants spent more time with ICA (23%) compared to unexposed infants (14%).
- ICA duration increased with dopamine dose, peaking at 11-15 μg/kg/min, and this association remained significant after controlling for confounding factors.
Conclusions:
- Dopamine exposure in the first 96 hours of life is associated with impaired cerebral autoregulation in preterm infants.
- The duration of ICA demonstrates a dose-dependent relationship with dopamine administration.
- These findings suggest careful consideration of dopamine use and its potential impact on cerebral hemodynamics in this vulnerable population.
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