Elsevier

The Journal of Pediatrics

Volume 110, Issue 2, February 1987, Pages 293-298
The Journal of Pediatrics

Dopamine pharmacokinetics in critically ill newborn infants*

https://doi.org/10.1016/S0022-3476(87)80176-2Get rights and content

To compare clinical responses with plasma concentrations of dopamine and to compare dopamine pharmacokinetics in infants of different gestational age or clinical condition, dopamine was administered under carefully controlled conditions of dose and rate of infusion. The dose was increased stepwise from 1 to 2, to 2 to 4, and 4 to 8μg/kg/min. Plasma concentrations of catecholamines including dopamine, were compared with blood pressure, heart rate, and Doppler cardiac output. The data were analyzed to determine the threshold or minimal plasma concentration of dopamine necessary to produce discernlble effects. Plasma clearance rate was calculated from steady-state plasma concentrations. The average threshold for increases in mean arterial pressure was 50% below that for increases in heart rate. Improvements in arterial pressure were noted before and at lower thresholds than for increases in heart rate. Serial echocardiographic data showed dose-dependent increases in cardiac output and stroke volume without significant change in heart rate or systemic vascular resistance. Thresholds and plasma clearance values were similar in infants of gestational age 27 to 42 weeks and birth weights 900 to 4300 g. Administration of dopamine at initial dosages lower than commonly recommended, followed by incremental increase in dose, may be associated with improved leff ventricular performance with avoidance of undesirable fachycardia and arrhythmias.

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    *

    Supported by Grants HD18014 and RR00425 from the National Institutes of Health and by a Basil O'Connor Starter Research Grant from the National Foundation March of Dimes.

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