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Evaluation of the causal effects between dopamine infusion changeover and fluctuations in mean arterial pressure in neonates

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posted on 2023-06-07, 06:44 authored by Katherine Kirupakaran, Paula de Sousa, Celine Le Roux, Lauren Redwood, Heike RabeHeike Rabe, Bhavik Anil Patel
Objective 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 Childhood

ISSN

0003-9888

Publisher

BMJ Publishing Group

Issue

4

Volume

105

Page range

390-394

Department affiliated with

  • BSMS Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2019-09-11

First Open Access (FOA) Date

2019-09-11

First Compliant Deposit (FCD) Date

2019-09-11

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