Document Detail

Epinephrine treatment of hypotension in very low birthweight infants.
MedLine Citation:
PMID:  12113327     Owner:  NLM     Status:  MEDLINE    
The aim of this study was to examine the influence of a continuous infusion of epinephrine (adrenaline) on mean arterial blood pressure (MABP), heart rate, urine output and base deficit in very low birthweight infants (VLBWI) with systemic hypotension. In VLBWI who received an infusion of epinephrine for at least 12 h the mean urine output, administered fluid volume, base deficit and administered buffer 12 h before and 12 h during the infusion were recorded. If the infusion was shorter, but given for at least 2 h, the mean heart rate and MABP 2 h before and 2 h during the infusion were recorded. Thirty-one infants with a gestational age of 26 (23-30) wk [median (minimum-maximum)] and birthweight 690 (390-1310) g were included in this retrospective chart review. The patients received an infusion of epinephrine at a postnatal age of 3 (1-21) d. The doses ranged between 0.05 and 2.6 microg kg(-1) per minute within the first 24 h of administration. Three of 31 infants received epinephrine on 2 different occasions. The MABP [+7 (-1 to 13) mmHg, p=0.000001] and the heart rate [+10 (-10 to 42) bpm, p=0.000036] increased significantly (n = 34), whereas total volume administration and urine output remained the same between the 2 periods (Wilcoxon matched pairs test). The base deficit increased significantly [-3 (-10.2 to 2.6), p = 0.0014, n = 19] without a change in the administration of buffer. Conclusion: The infusion of epinephrine increased the MABP and the heart rate without decreasing urine output in VLBWI with hypotension not responding to a dopamine infusion up to 15 microg kg(-1) per minute. A potential adverse effect was an increase in metabolic acidosis.
M Heckmann; A Trotter; F Pohlandt; W Lindner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  91     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2002  
Date Detail:
Created Date:  2002-07-12     Completed Date:  2003-01-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  566-70     Citation Subset:  IM    
Department of Pediatrics, University of Ulm, Germany.
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MeSH Terms
Blood Pressure / drug effects,  physiology
Cohort Studies
Dose-Response Relationship, Drug
Epinephrine / administration & dosage,  adverse effects*,  therapeutic use*
Gestational Age
Heart Rate / drug effects,  physiology
Hypotension / drug therapy*,  physiopathology
Infant, Newborn
Infant, Very Low Birth Weight
Infusions, Intravenous
Metabolic Diseases / chemically induced*,  physiopathology
Retrospective Studies
Vascular Diseases / chemically induced*,  physiopathology
Vasoconstrictor Agents / administration & dosage,  adverse effects*,  therapeutic use*
Reg. No./Substance:
0/Vasoconstrictor Agents; 51-43-4/Epinephrine
Comment In:
Acta Paediatr. 2002;91(5):500-2   [PMID:  12113314 ]

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