Document Detail


Left ventricular contractility in extremely premature infants in the first day and response to inotropes.
MedLine Citation:
PMID:  17314693     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim was to assess myocardial contractility in infants born <30 wk gestation developing low systemic blood flow (SBF) in the first day, and the effect of dobutamine versus dopamine. Superior vena cava (SVC) flow was used as a measure of SBF at 3, 10, and 24 h (n = 106). Infants with low SVC flow randomized to dopamine or dobutamine. Myocardial contractility was determined by the relationship between left ventricular (LV) mean velocity of circumferential fiber shortening (mVcfs) and wall stress. Infants who developed low SVC flow had significantly worse myocardial contractility at 3 h, but not 10 h. At 24 h, low-flow infants had lower than expected mVcfs for any given LV stress. In 37 infants randomized to inotrope, there was no significant difference in contractility at 10 microg/kg/min. At 20 microg/kg/min (n = 21), dopamine increased whereas dobutamine decreased LV stress. Infants on dobutamine had significantly lower than expected mVcfs for any given LV stress compared with infants on dopamine. Contractility was not improved by either inotrope at either dose. In conclusion, infants developing low SVC flow in the first day have worse myocardial contractility at 3 h. Neither inotrope increased contractility, but dopamine increased LV stress at 20 microg/kg/min.
Authors:
David A Osborn; Nick Evans; Martin Kluckow
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric research     Volume:  61     ISSN:  0031-3998     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-22     Completed Date:  2007-04-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  335-40     Citation Subset:  IM    
Affiliation:
RPA Newborn Care, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia. david.osborn@email.cs.nsw.gov.au
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity / drug effects,  physiology
Cardiotonic Agents / pharmacology*
Cohort Studies
Dobutamine / pharmacology*
Dopamine / pharmacology*
Female
Humans
Infant, Newborn
Infant, Premature
Male
Myocardial Contraction / drug effects,  physiology
Prospective Studies
Vascular Resistance / drug effects,  physiology
Ventricular Function, Left / drug effects*,  physiology*
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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