Hemodynamic and metabolic effects of a new pediatric dobutamine formulation in hypoxic newborn pigs

Mielgo, Victoria E, Vallis-i-Soller, Adolf, Lopez de Heredia, Juan M, Rabe, Heike and Rey-Santano, Carmen (2017) Hemodynamic and metabolic effects of a new pediatric dobutamine formulation in hypoxic newborn pigs. Paediatric Research, 81. pp. 511-518. ISSN 0031-3998

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Background: The aim of our study was to measure drug-related changes in hemodynamics and oxygen metabolism in response to different doses of an age-appropriate dobutamine formulation in hypoxic pigs. A secondary aim was to validate superior vena cava flow (SVCF) as a marker of cardiac index (CI) for subsequent clinical trials of this formulation in humans.

Methods: Newborn pigs (n=18) were exposed to 2h-hypoxia (10-15% oxygen) followed by reoxygenation (21-30% oxygen 4h). After 1h-reoxygenation, pigs were randomized to: control group (no treatment), dobutamine infusion at a rate of 10-15μg/kg/min or 15-20μg/kg/min. Dobutamine groups received two dobutamine doses during 30min with a 60min washout period between doses. Cardiovascular profile and oxygen metabolism were monitored. In four animals an ultrasonic perivascular flow probe was placed around superior vena cava to measure SVCF.

Results: Hypoxia significantly decreased CI, systemic-vascular-resistance and mean-arterial-bloodpressure (MABP). Dobutamine doses significantly increased heart-rate, CI and oxygen-delivery without changes in stroke-volume and MABP. Only 10-15μg/kg/min increased oxygen consumption and peripheral tissue oxygenation measured by Near-infrared-spectroscopy. A positive correlation was observed between SVCF and CI.

Conclusion: The new pediatric dobutamine formulation improved hemodynamic status, with dose-specific
differences in metabolic response. SVCF may be a useful surrogate for CI in subsequent clinical trials.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Subjects: R Medicine > RJ Pediatrics > RJ0251 Newborn infants Including physiology, care, treatment, diseases
Depositing User: Katie Isaac
Date Deposited: 22 Dec 2016 15:47
Last Modified: 02 Jul 2019 16:03
URI: http://sro.sussex.ac.uk/id/eprint/65986

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