The effect of low-dose dopamine infusion on cardiopulmonary and renal status in premature newborns with respiratory distress syndrome

Article Abstract:

Respiratory distress syndrome (RDS) often occurs in infants who are born prematurely. It is a severe problem that is often fatal. Pulmonary edema, the accumulation of fluid in the lungs, is one complication that may occur in infants with RDS. It is thought that, in these infants, pulmonary edema is caused by poor circulation and abnormal kidney functioning. Dopamine hydrochloride has been shown to improve both these problems when given in low doses. This study assessed whether giving infants with RDS low doses of dopamine during the first three days of life prevented pulmonary edema and improved their prognoses by enhancing circulation and kidney functioning. A total of 60 newborns with RDS were randomly assigned to one of three treatment groups: infants in group 1 served as control subjects; infants in group 2 received dopamine at a rate of 1 microgram per kilogram (ug/kg of body weight) per minute; and infants in group 3 were given dopamine at a rate of 2.5 ug/kg per minute. Results showed that at four and eight hours after beginning treatment, ventilator rates were significantly lower for infants in group 2 compared with those in group 1. Blood pressure and heart rate measurements were similar among the groups, as were blood gas levels (of oxygen and carbon dioxide) and pH (the level of acidity of the blood). Urine volume increased twice as much for groups 2 and 3 than for group 1 after 24 to 48 hours of treatment and to a lesser degree after 48 to 72 hours. Low blood pressure (hypotension) existed in seven infants in group 1, eight infants in group 2, and six infants in group 3 at the beginning of the study. Significant increases in blood pressure occurred in groups 2 and 3 after 16 hours of dopamine therapy, but were delayed in group 1 until 32 hours after the study began. Clinical outcomes did not vary among the groups. These results show that infusion of low doses of dopamine in infants with RDS slightly increases urine output and improves cardiovascular function in those with hypotension, but does not significantly affect clinical outcome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Drug therapy, Dosage and administration, Dopamine, Respiratory distress syndrome

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Retinopathy of prematurity in infants with cyanotic congenital heart disease

Article Abstract:

Retinopathy of prematurity (ROP, formerly called retrolental fibroplasia), an eye disorder in premature infants that can lead to blindness, has been thought to result from increased arterial oxygen tension (among other causes); this relationship, however, has not been unequivocally confirmed. Infants with cyanotic congenital heart disease (CCHD, inadequate heart activity such that the infant turns blue from lack of circulation) have low arterial oxygen tension (a measure of the amount of oxygen dissolved in the blood), and are believed to rarely develop ROP. This may not be the case, however. To learn more concerning the relationship between the two conditions, the records of six premature infants with CCHD who weighed between 1,100 and 2,050 grams were reviewed. All had undergone ophthalmologic examination at regular intervals after birth. The infants had been born at gestational ages ranging from 26 to 34 weeks; all had required mechanical ventilation (breathing with the aid of a machine). Three developed ROP; however, the abnormalities resolved within the first months of age in all cases. No differences were noted in the arterial oxygen tensions of the infants with or without ROP, or in the length of time oxygen was administered. A brief review is presented of the medical literature concerning the relationship between oxygen tension and ROP; the fact that infants with CCHD can also develop ROP, however, indicates that elevated oxygen tension is only one factor associated with the latter disease. Infants with CCHD should not be assumed to be free from ROP, and should be examined for symptoms as any other premature infant. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Causes of, Congenital heart defects, Congenital heart disease in children, Retrolental fibroplasia, Retinopathy of prematurity

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