PT - JOURNAL ARTICLE AU - D. P. Barker AU - J. Simpson AU - M. Pawula AU - D. A. Barrett AU - P. N. Shaw AU - N. Rutter TI - Randomised, double blind trial of two loading dose regimens of diamorphine in ventilated newborn infants. AID - 10.1136/fn.73.1.F22 DP - 1995 Jul 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - F22--F26 VI - 73 IP - 1 4099 - http://fn.bmj.com/content/73/1/F22.short 4100 - http://fn.bmj.com/content/73/1/F22.full SO - Arch Dis Child Fetal Neonatal Ed1995 Jul 01; 73 AB - AIMS--To compare the safety and efficacy of two loading doses of diamorphine in 27 ventilated newborn infants in a randomised double blind trial. METHODS--Fifty or 200 mcg/kg were infused intravenously over 30 minutes, followed by a 15 mcg/kg/hour continuous infusion. Serial measurements were made of physiology, behaviour, and stress hormones. RESULTS--Both loading doses produced small but significant falls in blood pressure. The 200 mcg/kg dose produced greater respiratory depression, and two infants deteriorated clinically, requiring resuscitation. Loading reduced respiratory effort in most of the infants, but had little effect on behavioural activity. Stress hormone concentrations were reduced at six hours in both dosage groups; differences between loading doses were not significant. Morphine, morphine-3-glucuronide, and morphine-6-glucuronide were detected in the plasma of all patients. No significant differences in concentrations between loading doses were found. CONCLUSIONS--Diamorphine reduces the stress response in ventilated newborn infants. A high loading dose confers no benefit, and may produce undesirable physiological effects. A 50 mcg/kg loading dose seems to be safe and effective.