Dobutamine DBL, Dobutrex
NICU and Dept. of Pharmacy
- 2-25 micrograms/kg/minute by continuous IV infusion.
- Begin at a low dose and titrate by monitoring effects.
- Administer via a central line (UVC, Longline,
or Surgical CVL). If no central access available, use a large vein.
- Usual dilution 30 mg/kg (2.4 ml/kg)
dobutamine to make 50 ml with NS or D5W
1 ml/hour = 10 micrograms/kg/minute.
(mg) in 50ml IV solution =
||3 x weight
(kg) x dose (micrograms/kg/min)
IV rate (ml/hr)
Maximum concentration = 5 mg/mL
- Blood pressure support in infants with shock and
Contraindications and Precautions
- Hypersensitivity to sympathomimetic amines and sodium metabisulfite.
- Hypovolaemia should be corrected prior to commencing the drug.
- Uncorrected tachyarrhythmia.
- Caution in infants with hypertension, LV outflow tract obstruction.
Dobutamine is a synthetic catecholamine with
primarily beta 1 adrenergic activity. It is an inotropic vasopressor. It
increases myocardial contractility, cardiac index, oxygen delivery and oxygen
consumption. It decreases systemic and pulmonary vascular resistance (adults).
The drug must be administered by continuous IV
infusion because of rapid metabolism of the drug. It is metabolised in the liver
to an inactive compound. The onset of action is 1-2 minutes after IV
administration with the peak effect occurring in 10 minutes. The half-life of
its drug effect is two minutes.
Possible Adverse Effects
- Venous irritation, soft tissue injury at site of IV infusion.
- May cause hypotension if patient is hypovolaemic.
- Tachycardia at high dosage.
- Arrhythmias, hypertension especially systolic pressure and cutaneous vasodilatation.
- Volume loading is recommended before commencing dobutamine infusion.
- Renal dysfunction: no dosage adjustment necessary.
- Clinical experience with dobutamine in neonates is limited. Whether
dobutamine has any consistent advantages over dopamine in the treatment of a
neonate with myocardial dysfunction remains to be established.
- Beta blockers may antagonise dobutamine effect.
- General anaesthetics: greater incidence of ventricular arrhythmias.
- Dobutamine should not be used with agents containing sodium bisulfite.