Observational study of cerebral hemodynamics during dopamine treatment in hypotensive ELBW infants on the first day of life

Objective:to evaluate cerebral hemodynamics during dopamine treatment in hypotensive (mean arterial blood pressure (mabp)study design:continuous monitoring of cerebral blood flow velocity (cbfv), mabp and pco2 was performed in hypotensive elbw infants on the first day of life, beginning with an ∼15-min baseline reading and continued during advancing dopamine infusion until mabp was optimized. physiological variables and cbfv reactivity were compared before and after mabp was optimized.result:fifteen hypotensive elbw infants (625±174 g; 24 (23 to 24.8) weeks) were studied. mean cbfv increased from 10.9±3.7 to 15.7±5.7 cm s−1 (p=0.001) simultaneously as mabp increased from 22.3±2.8 to 35.2±9.7 mm hg (p<0.001). mean cbfv reactivity (95% confidence interval (ci)) was 3.9 (1.6 to 6.2) %mm hg−1. nine infants died and/or developed severe intraventricular hemorrhage (ivh).conclusion:mean cbfv increased pressure-passively as mabp was optimized by dopamine treatment in very sick hypotensive elbw infants on the first day of life.