کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2955340 1577499 2006 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Adverse Effects of Dopamine on Systemic Hemodynamic Status and Oxygen Transport in Neonates After the Norwood Procedure
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Adverse Effects of Dopamine on Systemic Hemodynamic Status and Oxygen Transport in Neonates After the Norwood Procedure
چکیده انگلیسی

ObjectivesThe purpose of this study was to evaluate the effects of dopamine on hemodynamic status and oxygen transport in neonates after the Norwood procedure.BackgroundDopamine is widely used to augment cardiac performance and increase oxygen delivery (Do2) in patients after cardiopulmonary bypass (CPB). This might be at the expense of increased myocardial and systemic oxygen consumption (Vo2), thus offsetting the improved Do2. This balance is particularly fragile in critically ill neonates.MethodsSystemic oxygen consumption was continuously measured with respiratory mass spectrometry in 13 sedated, paralyzed, and mechanically ventilated neonates for 72 h after the Norwood procedure. Arterial, superior vena caval, and pulmonary venous blood gases were measured to calculate pulmonary blood flow (Qp) and systemic blood flow (Qs), Do2, and oxygen extraction ratio (ERo2). Rate-pressure product was calculated. Dopamine at a dose of 5 μg/kg/min was routinely administered at cessation of CPB and terminated within the first 48 h. Hemodynamic and oxygen transport measures were obtained before and at 100 min after the termination of dopamine.ResultsTerminating dopamine was not associated with significant changes in arterial pressure, Qp, Qs, or Do2but was associated with a significant decrease in heart rate (p = 0.003), rate-pressure product (p = 0.03), and Vo2(−20 ± 11%, p < 0.0001), resulting in a significant decrease in ERo2(p = 0.01).ConclusionsDopamine induces a significant increase in Vo2in neonates after the Norwood procedure, and termination is associated with an improved balance of Vo2–Do2. These data further emphasize the importance of understanding changes in Vo2as well as Do2in infants after cardiac surgery.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Cardiology - Volume 48, Issue 9, 7 November 2006, Pages 1859–1864
نویسندگان
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