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

This study aimed to determine cardioyascular 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 withmildHMDwith thebirthweight of >1250 grams, andagedless than48 hours. All measurements were done by using non-inyasive methods, i.e., echocardiography and/or Doppler technique. RV diastolic function parameters (points E and A, and AA ratia) were not significantly dffirent betvveen infants with or without mild HMD, and dobutamine did not alter the values. In contrast, LV E and A points were signifcantly dffirent between the two Sroups, although the E/A ratio was not dffirent. InfantswithmildHMD hadsignificantly longerrate-correctedPEP, shorterratecorrectedLVET, andlarger PEP4LVET ratio compared with those without HMD.The LV diastotic and systolic dysfunctionswereimprovedby dobutamine. Cerebralbloodflowvelocity (CBFV) determined by Doppler at the antertor cerebral artery showed that maximal and minimal flows, Pourcelot Index, and flow acceleration were not dffirent betvveen infants with or without HMD. Dobutamine did not alter CBFV but increased bloodflow 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.