|
|
|
Faculty of Health Sciences
School of Medicine
Department of Obstetrics and Gynaecology
A comparison of the effect, on urinary output and cardiac function, of either low-dose Dopamine infusion or Albumin infusion in severely ill pre-eclamptic patients with poor urinary output. A randomised controlled trial.
In the Pretoria Academic Complex it is standard protocol to give low-dose Dopamine infusion to pre-eclamptic patients with a urinary output less than 30ml/hour for two consecutive hours. This stands in contrast ot the recommendations formulated in The Why Mothers Die 1997-1999 report published by the Royal College who gives these patients Human Albumin solution. With this study we want to determine which treatment option is the best since there are no other published randomised control trials that compare there treatment options. The study will take place in the high care obstetrics unit at Kalafong Hospital. All patients who are in the process of delivery and have severe pre-eclampsia with a urinary output less that 30ml/hr for 2 consecutive hours will be asked to participate and those agreeing will give written consent. These women will have an echocardiography to measure their central venous pressure (CVP) and evaluate their cardiac function. Randomisation to either receive a low-dose dopamine infusion starting at 1um/kg/min intravenously or Albusol 20% 100ml Solution. After this treatment the patient's cardiac function and CVP will again be re-evaluated with echocardiography. The patient's urinary output will also be measured. Pre and post treatment changes in cardiac function will also be compared. These women will all be post delivery or in the process of being delivered. The end points would be urinary output more than 30ml/hr, pulmonary oedema, and kidney failure requiring dialysis. The study will also be valuable in identifying critical echocardiographic measurements that could be useful in the managing of these patients. The attending physician will not be blind as to treatment the patient receives but will not receive any information regarding the cardiac function evaluation. The reason for this is that this is one part of a larger study that will evaluate to what extent cardiac echography evaluation can be used in the management of women with severe pre-eclampsia.
|
|
|
|
