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. 1997 May;76(3):F174–F178. doi: 10.1136/fn.76.3.f174

Randomised trial of dopamine compared with hydrocortisone for the treatment of hypotensive very low birthweight infants

D Bourchier, P Weston
PMCID: PMC1720650  PMID: 9175947

Abstract

AIM—To compare the efficacy of hydrocortisone with dopamine for the treatment of hypotensive, very low birthweight (VLBW) infants.
METHODS—Forty infants were randomly allocated to receive either hydrocortisone (n=21) or dopamine (n=19).
RESULTS—All 19 infants randomised to dopamine responded; 17 of 21 (81%) did so in the hydrocortisone group. Three of the four non-responders in the hydrocortisone group had clinically significant left to right ductal shunting. The incidence of bronchopulmonary dysplasia, retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, symptomatic patent ductus arteriosus, hyperglycaemia, sepsis (bacterial or fungal) or survival did not differ between groups. The adrenocorticotrophic hormone (ACTH) stimulated plasma cortisol activity, either before or after treatment, did not differ between the two groups of infants. Although a significant difference in efficacy between dopamine and hydrocortisone was not noted (P = 0.108), there were four treatment failures in the hydrocortisone group, compared with none in the dopamine group.
CONCLUSION—Both hydrocortisone and dopamine are effective treatments for hypotension in very low birthweight infants.

 Keywords: hydrocortisone; dopamine; hypotension; very low birthweight; plasma cortisol

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Figure 1  .

Figure 1  

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Blood pressure changes over time. Average MAPs at each recording time are shown for both groups as increments above target MAPs (as target MAP varied with birthweight). Data from the four infants who failed in the hydrocortisone group are excluded from the time they stopped receiving hydrocortisone. Vertical bars indicate standard deviations (SD).

Figure 2  .

Figure 2  

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Proportion of infants with MAP above target value in first 12 hours after treatment.

Selected References

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