Association between amount of dopamine and infections in extremely preterm infants
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ORIGINAL ARTICLE
Association between amount of dopamine and infections in extremely preterm infants Masashi Hotta 1
&
Katsuya Hirata 1 & Masatoshi Nozaki 1 & Narutaka Mochizuki 1 & Shinya Hirano 1 & Kazuko Wada 1
Received: 2 February 2020 / Revised: 28 April 2020 / Accepted: 6 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract This study aimed to assess the effect of dopamine on the development of infections after birth in extremely preterm infants. We retrospectively identified 258 extremely preterm infants (born at < 28 gestational weeks) between July 2009 and December 2018 in a tertiary neonatal intensive care unit (NICU). We extracted data on potential risk factors for infection, total amount of dopamine, and infection history during NICU stay for each infant. We compared the infection group with the non-infection group, and used the Cox proportional hazard regression analysis to identify risk factors for infection during NICU stay. After adjustment for all potential risk factors, factors that significantly affected development of infection were gestational age (hazard ratio [HR], 0.70; 95% confidence interval [CI] 0.55–0.89; p = 0.004) and total amount of dopamine (HR, 1.04; 95% CI 1.02– 1.07; p = 0.002). The receiver operating characteristic curve of total amount of dopamine for infection suggested that total amount of dopamine greater than 7.271 mg/kg predicted infection development with 80.4% sensitivity and 41.7% specificity. Conclusion: A large amount of dopamine can increase infections in extremely preterm infants. We should avoid using a large amount of dopamine and remain aware of the potential development of infections in extremely preterm infants. What is Known: • Inotropes are often used for extremely preterm infants and dopamine is the most commonly used inotrope. • However, it is suggested that dopamine affects the immune system and related infections. What is New: • This is the first study of the association between the amount of dopamine and infection in extremely preterm infants. • We should avoid using a large amount of dopamine in extremely preterm infants.
Keywords Dopamine . Extremely preterm infants . Infection . Neonate Abbreviations AUC Areas under the curve BSI Blood stream infection
CDC/ NSHN CI
The Centers for Disease Control and Prevention and National Healthcare Safety Network Confidence interval
Responsible Editor:Daniele De Luca Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00431-020-03676-7) contains supplementary material, which is available to authorized users. * Masashi Hotta [email protected]
Shinya Hirano [email protected] Kazuko Wada [email protected]
Katsuya Hirata [email protected] Masatoshi Nozaki [email protected] Narutaka Mochizuki [email protected]
1
Department of Neonatal Medicine, Osaka Women’s and Children’s Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
Eur J Pediatr
CRIB NICU HR ROC
Clinical Risk Index for Babies Neonatal intensive care unit Hazard
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