Babies who are born prematurely face many critical situations that can affect their health and quality of life. Low blood pressure, also known as hypotension, reduces the amount of blood circulating through the body. This creates a dangerous situation for a baby who needs blood to oxygenate her tissues and to fight infection. Hypotension can be treated in preemies through several routes, including administration of a fluid bolus, giving blood or administering dopamine.
Dopamine works to help the heart beat harder by stimulating certain receptors that increase the force of contractions. This helps the heart to pump more blood to the body’s tissues and increases the blood pressure. Dopamine also occurs naturally in the body as a type of hormone that is secreted by the brain. It is associated with regulation of nerves and feelings of pleasure. Dopamine given as a medication does not cross the blood-brain barrier, therefore it does not have an impact on the nervous system.
A preterm baby who has an infection must use most of his energy to work against it. A baby’s body may send extra blood to the site of infection, resulting in low blood pressure overall. This reduces the amount of blood received by the other tissues and can cause organ damage. Administering dopamine to a baby who is infected can help his heart to pump and distribute blood to fight illness and maintain the health of his other organs.
Difficulties during delivery may occur that can cause blood loss. Because a premature baby is small, he has less blood circulating through his body and can be affected by a small amount of blood loss. His premature body also does not have the capability or speed to manufacture red blood cells at a pace that can prevent hypotension. Dopamine and a fluid bolus may be given in these situations to maintain blood pressure, restore blood and fluids, and give the baby some time to generate new blood.
Dopamine is administered intravenously, as it acts quickly upon entering the blood stream. According to Drugs.com, dopamine has a half life of approximately two minutes, meaning the dose is already reduced by half after two minutes. Because of this, dopamine is frequently administered as a constant intravenous drip for many babies while their blood pressure is monitored. A baby may receive dopamine and the dose can be reduced when her blood pressure stabilizes. Dopamine is always diluted with another solution such as normal saline before use, as it is potent.
Side effects of dopamine administered to a preterm infant include hypertension, vasoconstriction and irregular heartbeat. A baby receiving dopamine may respond well to the therapy, causing the blood vessels to constrict with an increase in blood pressure. Additionally, the action of dopamine to increase the heart’s effectiveness may cause an increase in heart rate or extra heartbeats.