Understanding the Stability of Dopamine and Dobutamine Over 24 h in Simulated Neonatal Ward Conditions
Our objectives were to investigate the possible effects of temperature and light on the stability of dopamine and dobutamine continuous infusions over 24 h when prepared in a variety of dilution vehicles.
Syringe-driver infusion apparatuses were set up for dopamine and dobutamine diluted with either 0.9% sodium chloride (NaCl) or 5% glucose delivering 3 and 5 μg/kg/min, respectively, via 206-cm extension sets. All infusions were prepared for a neonate weight of 1 kg. Infusions were run over 24 h with approximately half the tubing within an incubator set at 35 °C. Cyclic voltammetry was used to monitor the concentration of the inotrope within the syringe and at the end of the extension set, both initially and after 24 h.
The variation in the concentration of dopamine and dobutamine in the vials (n = 6) was 3.58 and 1.22%, respectively. This variation increased to 10.88% for dopamine and 5.76% for dobutamine in the syringe. After 24 h, a significant reduction in the concentration of dopamine was observed at the end of the extension set when prepared in 0.9% NaCl versus 5% glucose (p < 0.001; n = 6–7) and in dobutamine when prepared in 0.9% NaCl (p < 0.001; n = 6–7). No differences in the concentration of dopamine prepared in 0.9% NaCl were observed after 24 h in light-exposed and light-protected extension sets (n = 6–7).
Dobutamine is more stable in dilution vehicles than dopamine, and inotropes are more stable in the 5% glucose dilution vehicle than in 0.9% NaCl. Such findings will provide guidance on the choice of inotropes.
The authors thank the nursing staff of the Department of Neonatology, Brighton and Sussex University Hospitals, for the valuable advice on the practical part of the study.
Data collection, analysis, and interpretation were conducted by KK. Data interpretation and conception or design of the study was conducted by LM, HR, and BAP. The manuscript was drafted by BAP, with revision for important intellectual content and final approval of the version to be published provided by KK, LM, and HR.
Compliance with Ethical Standards
The study was partly supported by FP7-HEALTH Grant No. 282533 NEO-CIRCulation.
Conflict of interest
Katherine Kirupakaran, Liam Mahoney, Heike Rabe, and Bhavik A. Patel have no conflicts of interest that might be relevant to the contents of this manuscript.
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