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1 Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington 98195-6320; and 2 Departments of Pediatrics and Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
Preterm infants are
often treated with intravenous dopamine to increase mean arterial blood
pressure (MAP). However, there are few data regarding cerebrovascular
responses of developing animals to dopamine infusions. We studied eight
near-term and eight preterm chronically catheterized unanesthetized
fetal sheep. We measured cerebral blood flow and calculated cerebral
vascular resistance (CVR) at baseline and during dopamine infusion at
2.5, 7.5, 25, and 75 µg · kg
1 · min
1. In
preterm fetuses, MAP increased only at 75 µg · kg
1 · min
1 (25 ± 5%), whereas in near-term fetuses MAP increased at 25 µg · kg
1 · min
1 (28 ± 4%) and further at 75 µg · kg
1 · min
1 (51 ± 3%). Dopamine infusion was associated with cerebral
vasoconstriction in both groups. At 25 µg · kg
1 · min
1, CVR
increased 77 ± 51% in preterm fetuses and 41 ± 11% in
near-term fetuses, and at 75 µg · kg
1 · min
1, CVR
increased 80 ± 33% in preterm fetuses and 83 ± 21% in
near-term fetuses. We tested these responses to dopamine in 11 additional near-term fetuses under
-adrenergic blockade
(phenoxybenzamine, n = 5) and under dopaminergic
D1-receptor blockade (SCH-23390, n = 6).
Phenoxybenzamine completely blocked dopamine's pressor and cerebral
vasoconstrictive effects, while D1-receptor blockade had no
effect. Therefore, in unanesthetized developing fetuses, dopamine
infusion is associated with cerebral vasoconstriction, which is likely
an autoregulatory,
-adrenergic response to an increase in blood pressure.
brain; fetus; vasoconstriction
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