Abstract
Background
To test the hypothesis that dopamine is associated with impaired cerebral autoregulation (ICA) in a dose-dependent fashion.
Methods
Non a priori designed secondary analysis of a prospectively enrolled cohort study subjects <12 h of life between 240 and 296 weeks gestation. Cerebral saturations (rScO2) and mean arterial blood pressure (MAP) were continuously monitored every 30 s for 96 h. ICA was defined by a 10 min epoch rScO2-MAP correlation coefficient of >0.5.
Results
Twenty-three of 61 subjects (38%) required dopamine. Time spent with ICA was 23% in dopamine-exposed subjects vs. 14% in those not exposed (p = 0.0001). On the epoch level, time spent with ICA was 15%, 29%, 34%, 37%, and 23% in epochs with dopamine titration of 0, 1–5, 6–10, 11–15, and 16–20 μg/kg/min, respectively. Using mixed-effect modeling, ICA for each dopamine titration was significantly higher than unexposed times when controlling for gestation, presence of a patent ductus arteriosus, day of life, MAP less than gestational age, and illness severity score (p < 0.02).
Conclusions
Dopamine exposure during the first 96 h was associated with ICA. Time periods with ICA increased with dopamine exposure in a dose-dependent fashion peaking at a concentration of 11–15 μg/kg/min.
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Acknowledgements
This work was funded by the Mentored Population and Clinical Research Program of the American Heart Association, Award #14CRP18140003 to S.B.H.
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N.S.S. was responsible for the original draft, collection, analysis and interpretation of data, and drafting and revising the manuscript. S.B.H. was responsible for the concept and design, collection, analysis and interpretation of data, and drafting and revising the manuscript. Both authors have approved the manuscript as submitted.
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Solanki, N.S., Hoffman, S.B. Association between dopamine and cerebral autoregulation in preterm neonates. Pediatr Res 88, 618–622 (2020). https://doi.org/10.1038/s41390-020-0790-0
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DOI: https://doi.org/10.1038/s41390-020-0790-0
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