儿茶酚胺对早产儿血流的影响:PICC-MBF试验的亚分析。

IF 2.6 3区医学 Q1 PEDIATRICS

Neonatology Pub Date : 2023-01-01 Epub Date: 2023-09-01 DOI:10.1159/000532017

Akio Ishiguro, Kazuhiko Kabe

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引用次数: 0

摘要

本研究评估了极低出生体重(VLBW)婴儿皮肤血流量与全身血流量的相关性，以及皮肤血流量是否可以决定多巴胺和多巴酚丁胺对血流量的循环作用。方法:本研究是PICC-MBF随机对照试验的亚分析。检查皮肤血流量与超声心动图结果的相关性。同时评估了多巴胺和多巴酚丁胺开始或剂量增加前后皮肤血流量和血压的变化。结果:234名参与者接受了超声心动图检查。皮肤血流量与腔静脉上(SVC)血流显著相关(r = 0.31, p <0.001)。受试者算子特征分析显示，皮肤血流量17 mL/min有效检测SVC血流量41 mL/min(曲线下面积= 0.83,p <0.001)。多巴酚丁胺在起始或剂量增加后显著增加皮肤血流量(p = 0.033)，但没有升高血压。然而，多巴胺显著增加皮肤血流量(p = 0.010)和血压(p <0.001)。结论:我们的研究结果表明，皮肤血流量可以作为VLBW婴儿全身血流量的替代标志物，并揭示了多巴胺和多巴酚丁胺对循环的影响的差异。

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Effects of Catecholamines on Blood Flow in Preterm Infants: A Subanalysis of PICC-MBF Trial.

Introduction: This study evaluated the correlation between skin blood flow and systemic blood flow and whether skin blood flow can determine the circulatory effects of dopamine and dobutamine on blood flow in very low birth weight (VLBW) infants.

Methods: This study was a subanalysis of the PICC-MBF randomized controlled trial. The correlation between skin blood flow and echocardiographic findings was examined. Changes in skin blood flow and blood pressure before and after initiation or dose increase of dopamine and dobutamine were also evaluated.

Results: Two hundred and thirty-four participants underwent echocardiography. Skin blood flow was significantly correlated with supra vena cava (SVC) flow (r = 0.31, p < 0.001). Receiver operator characteristic analysis revealed that skin blood flow <17 mL/min effectively detected SVC flow <41 mL/min (area under the curve = 0.83, p < 0.001). Dobutamine significantly increased skin blood flow after initiation or dose increase (p = 0.033) without increasing blood pressure. However, dopamine significantly increased both skin blood flow (p = 0.010) and blood pressure (p < 0.001).

Conclusions: Our findings indicated that skin blood flow could be used as a surrogate marker of systemic blood flow in VLBW infants and revealed differences in the effects of dopamine and dobutamine on circulation.

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来源期刊

Neonatology 医学-小儿科

CiteScore

0.60

自引率

4.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This highly respected and frequently cited journal is a prime source of information in the area of fetal and neonatal research. Original papers present research on all aspects of neonatology, fetal medicine and developmental biology. These papers encompass both basic science and clinical research including randomized trials, observational studies and epidemiology. Basic science research covers molecular biology, molecular genetics, physiology, biochemistry and pharmacology in fetal and neonatal life. In addition to the classic features the journal accepts papers for the sections Research Briefings and Sources of Neonatal Medicine (historical pieces). Papers reporting results of animal studies should be based upon hypotheses that relate to developmental processes or disorders in the human fetus or neonate.