AI Article Synopsis
- The study investigates how different treatments affect blood flow in newborn piglets that experienced oxygen deprivation and recovery.
- Both high-dose dopamine and a combination of dopamine with epinephrine improved overall heart circulation, but they affected blood flow in the lungs and intestines differently.
- Overall, both treatments offered similar benefits for systemic blood flow, but the combination with epinephrine showed distinct advantages in pulmonary and mesenteric circulation.
Article Abstract
Background: When asphyxiated neonates require additional cardiovascular support to moderate doses of dopamine infusion, controversy exists on the differential hemodynamic effects of two approaches (adding a second inotrope vs. increasing dopamine dosage). We hypothesized that high-dose dopamine (HD) would be detrimental to systemic and regional perfusion as compared with dopamine and epinephrine (D + E) combination therapy using a swine model of neonatal hypoxia-reoxygenation (H-R).
Methods: Twenty-seven piglets (1-4 d, 1.5-2.5 kg) were used for continuous monitoring of systemic arterial pressure (mean arterial pressure, MAP) and pulmonary arterial pressure (PAP), cardiac output (cardiac index, CI), and carotid (carotid artery flow index, CAFI), superior mesenteric (superior mesenteric artery flow index), and renal arterial flows. H-R piglets underwent 2 h of hypoxia followed by 2 h of reoxygenation before drug infusion (2 h).
Results: The hemodynamics of H-R piglets deteriorated gradually after reoxygenation. HD and D + E infusions improved CI similarly (both groups vs. control; P < 0.05). Both regimens increased MAP (P < 0.05) but not PAP, with decreased PAP/MAP ratio in D + E piglets. Both regimens improved CAFI and superior mesenteric artery flow index, with decreased mesenteric vascular resistance in HD-treated piglets. No significant effect on renal perfusion was observed.
Conclusion: In H-R newborn piglets treated with a moderate dose of dopamine, adding epinephrine or further increasing dopamine improved systemic hemodynamics similarly; these treatments have differential effects on the pulmonary and mesenteric circulations.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972577 | PMC |
| http://dx.doi.org/10.1038/pr.2013.17 | DOI Listing |
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