RT Journal Article
SR Electronic
T1 Randomised trial of dopamine compared with hydrocortisone for the treatment of hypotensive very low birthweight infants
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F174
OP F178
DO 10.1136/fn.76.3.F174
VO 76
IS 3
A1 David Bourchier
A1 Philip J Weston
YR 1997
UL http://fn.bmj.com/content/76/3/F174.abstract
AB AIM To compare the efficacy of hydrocortisone with dopamine for the treatment of hypotensive, very low birthweight (VLBW) infants. METHODS Forty infants were randomly allocated to receive either hydrocortisone (n=21) or dopamine (n=19). RESULTS All 19 infants randomised to dopamine responded; 17 of 21 (81%) did so in the hydrocortisone group. Three of the four non-responders in the hydrocortisone group had clinically significant left to right ductal shunting. The incidence of bronchopulmonary dysplasia, retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, symptomatic patent ductus arteriosus, hyperglycaemia, sepsis (bacterial or fungal) or survival did not differ between groups. The adrenocorticotrophic hormone (ACTH) stimulated plasma cortisol activity, either before or after treatment, did not differ between the two groups of infants. Although a significant difference in efficacy between dopamine and hydrocortisone was not noted (P = 0.108), there were four treatment failures in the hydrocortisone group, compared with none in the dopamine group. CONCLUSION Both hydrocortisone and dopamine are effective treatments for hypotension in very low birthweight infants.