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Combination vasoactive medication use in asphyxiated newborn piglets Open Access


Other title
Neonatal Asphyxia
Vasoactive Medication
Type of item
Degree grantor
University of Alberta
Author or creator
Manouchehri, Namdar
Supervisor and department
Bigam, David (Surgery)
Cheung, Po-Yin (Pediatrics, Pharmacology and Surgery)
Examining committee member and department
Joynt, Chloe (Pediatrics)
Churchill, Thomas (Surgery)
Department of Surgery

Date accepted
Graduation date
Master of Science
Degree level
With asphyxia, newborns may suffer cardiogenic shock with myocardial dysfunction and dysregulation of vasomotor tone resulting in multiorgan dysfunction. Vasoactive medications are often administered with limited evidence directing clinicians regarding the use of high-dose monotherapy with dopamine relative to combination treatment with dopamine and a second different agent. We hypothesized that the treatment of hypoxia-reoxygenated newborn piglets with combinations of vasoactive medications would improve systemic and regional hemodynamics. Instrumented newborn piglets were subjected to hypoxia-reoxygenation with subsequent infusion of high-dose dopamine or moderate-dose dopamine and one of epinephrine, milrinone or levosimendan. Treatment with high-dose dopamine improved systemic and mesenteric perfusion. The addition of low-dose epinephrine showed some benefits regarding pulmonary hypertension and should a non-catecholamine agent be added to dopamine, milrinone is preferred to levosimendan given benefits to mesenteric perfusion. We conclude that the selection of appropriate vasoactive medical therapy should be directed by the clinical effects desired.
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File author: Namdar Manouchehri
Page count: 169
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