Neonate Dopamine Paper REVISED CLEAN.pdf (344.22 kB)
Evaluation of the causal effects between dopamine infusion changeover and fluctuations in mean arterial pressure in neonates
journal contribution
posted on 2023-06-07, 06:44 authored by Katherine Kirupakaran, Paula de Sousa, Celine Le Roux, Lauren Redwood, Heike RabeHeike Rabe, Bhavik Anil PatelObjective To evaluate whether changing dopamine infusions every 12?hours and preparing these infusions 30?min before administration reduces blood pressure fluctuations in preterm and term neonates. Design This was a retrospective study using data from live patients on the neonatal unit and prospective study exploring stability of infusions in a laboratory-based neonatal ward simulation. Setting Single-centre study in a tertiary neonatal surgical unit in a university teaching hospital. Patients Neonates who received more than one subsequent dopamine infusion and had invasive arterial blood pressure monitoring, during their admission in the neonatal unit, were included. Interventions As part of the Quality Improvement project, the standard operating procedure (SOP) was changed, and dopamine infusions were prepared by nursing staff and left to rest for 30?min before administering to the neonate. Additionally, infusions were replaced every 12?hours. Main outcome measures The percentage change in mean arterial pressure (MAP) and the percentage loss in the drug concentration during infusion during changeover. Results Our findings indicate that up to 15% of the initial dopamine concentration is lost after 24?hours. This results in a sharp variation in the dopamine concentration during infusion changeover that correlates with observed rapid fluctuations in MAP. In changing the SOP, no significant difference in the concentration of dopamine and MAP were observed over 12?hours. Conclusions Delaying administration of dopamine infusions by 30?min after preparation combined with changing infusions 12 hourly has reduced MAP fluctuations. Therefore, the risks associated with MAP fluctuations, including intraventricular haemorrhages, are reduced.
History
Publication status
- Published
File Version
- Accepted version
Journal
Archives of Disease in ChildhoodISSN
0003-9888Publisher
BMJ Publishing GroupExternal DOI
Issue
4Volume
105Page range
390-394Department affiliated with
- BSMS Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2019-09-11First Open Access (FOA) Date
2019-09-11First Compliant Deposit (FCD) Date
2019-09-11Usage metrics
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