Current Usage of Dopamine in New Zealand Intensive Care Units

A nation-wide evaluation of dopamine usage in New Zealand Intensive Care Units (ICUs) was undertaken. Twenty-six public hospital ICUs participated. Twenty-two ICUs (85%) use dopamine as an inotrope. Seventeen ICUs use dopamine for presumed selective renal effects at least occasionally, but with wide variation in what is considered to be "renal-dose". Level 3 ICUs were less likely to use "renal-dose" dopamine than levels 1 and 2 (P= 0.01). Nineteen units (83%) use weight-referenced (i.e., microg x kg(-1) x min(-1)) dopamine administration. Weight-referenced administration and "renal-dose" dopamine were likely to be in use together (P=0.02). Standard dopamine dilutions varied widely with a median of 2 mg x ml(-1) (range 0.4 to 8 mg x ml(-1)). Given a demonstrated association between weight-referenced administration and "renal-dose" dopamine, along with particular pharmacokinetic and pharmacodynamic reservations, the value of weight-referenced administration of dopamine in adult patients is questioned.