Effects of dobutamine on ventricular functions and cerebral blood flow in preterm infants with mild hyaline membrane disease

Abstract

This study aimed to determine cardiovascular involvement in mild hyaline membrane disease (HMD) and its response to dobutamine administration. The study was done at Dr. Cipto Mangunkusumo Hospital, Jakarta, from November 1997 to May 1998. Study subjects were preterm infants with mild HMD with the birth weight of >1250 grams, and aged less than 48 hours. All measurements were done by using non-invasive methods, i.e., echocardiography and/or Doppler technique. RV diastolic function parameters (points E and A, and E/A ratio) were not significantly different between infants with or without mild HMD, and dobutamine did not alter the values. In contrast, LV E and A points were significantly different between the two groups, although the E/A ratio was not different. Infants with mild HMD had significantly longer rate-corrected PEP, shorter rate- corrected LVET, and larger PEP/LVET ratio compared with those without HMD. The LV diastolic and systolic dysfunctions were improved by dobutamine. Cerebral blood flow velocity (CBFV) determined by Doppler at the anterior cerebral artery showed that maximal and minimal flows, Pourcelot Index, and flow acceleration were not different between infants with or without HMD. Dobutamine did not alter CBFV but increased blood flow acceleration. It is concluded that LV diastolic and systolic functions are depressed in mild HMD; and dobutamine can correct the dysfunction; however, RV diastolic function is not disturbed in mild HMD. CBFV is not altered in mild HMD; dobutamine has negligible effect on CBFV, but it increases CBF acceleration.