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Supranormal cardiac output in the dopamine- and dobutamine-dependent preterm infant

S L Lopez1, J O Leighton, F J Walther

  • 1Department of Pediatrics, Martin Luther King Jr./Drew University Medical Center and University of California Los Angeles School of Medicine, Los Angeles, CA 90059, USA.

Pediatric Cardiology
|July 1, 1997
PubMed

Insights

High cardiac output is common in preterm infants with respiratory distress syndrome (RDS) receiving dopamine and dobutamine. This increased cardiac output is not reflected in their blood pressure, indicating a potential disconnect in cardiovascular assessment.

Area of Science:

  • Neonatalogy
  • Pediatric Cardiology
  • Critical Care Medicine

Background:

  • Respiratory distress syndrome (RDS) is a common condition in preterm infants.
  • Cardiovascular dysfunction, including low cardiac output, can complicate RDS management.
  • Inotropic support is frequently used in preterm infants with RDS.

Purpose of the Study:

  • To evaluate the incidence of low cardiac output in preterm infants with RDS.
  • To compare hemodynamic parameters in preterm infants with RDS receiving inotropic support versus controls.
  • To investigate the relationship between inotropic therapy and cardiac output in RDS.

Main Methods:

  • Cardiac output, stroke volume, heart rate, mean arterial blood pressure, and systemic vascular resistance were measured in preterm infants with RDS.
  • Infants were categorized based on RDS status and inotropic support (dopamine, dobutamine).
  • Hemodynamic data were compared between groups.

Main Results:

  • Infants with RDS had higher cardiac output and lower systemic vascular resistance and blood pressure than controls.
  • Infants on dopamine and dobutamine showed higher cardiac output and heart rate but lower blood pressure and systemic vascular resistance than normotensive controls.
  • Supranormal cardiac output (>400 ml/min/kg) was observed in 57% of infants receiving dopamine + dobutamine.

Conclusions:

  • High cardiac output is common in preterm infants with RDS treated with dopamine and dobutamine.
  • Elevated cardiac output in these infants may not correlate with blood pressure.
  • Further research is needed to understand the implications of high cardiac output in RDS.

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