DOPAMINE, DOPEXAMINE AND DOBUTAMINE IN LIVER-TRANSPLANT RECIPIENTS - A COMPARISON OF THEIR EFFECTS ON HEMODYNAMICS, OXYGEN-TRANSPORT AND HEPATIC VENOUS OXYGEN-SATURATION

The purpose of this study was to determine the effects of vasoactive t reatment with dopamine (DO), dopexamine (DX), and dobutamine (DOE) on hemodynamics, oxygen transport and hepatic venous oxygen saturation (S vhO(2)) after orthotopic liver transplantation (OLT). A pulmonary arte ry catheter was inserted into the right hepatic vein of 17 OLT patient s. Timed infusion of DO, DX, and DOB was performed at the following ra tes: DO at 4 and 8 mu g/kg per minute, DX at 4 and 8 mu g/kg per minut e, and DOB at 5 and 10 mu g/kg per minute. Hemodynamics, oxygen transp ort variables, and SvhO(2) were assessed. Each catecholamine induced a significant increase in cardiac index, oxygen delivery, and SvhO(2). Mean arterial pressure was increased during DO and DOB, but significan tly reduced during DX. Each inotrope increased oxygen delivery in para llel with SvhO(2), suggesting a corresponding increase in hepatic oxyg en supply. Therefore, it appears that each vasoactive drug may be util ized in OLT patients to provide oxygen delivery without impairment of splanchnic oxygenation.