R. Neviere et al., THE CONTRASTING EFFECTS OF DOBUTAMINE AND DOPAMINE ON GASTRIC-MUCOSALPERFUSION IN SEPTIC PATIENTS, American journal of respiratory and critical care medicine, 154(6), 1996, pp. 1684-1688
Citations number
33
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
To test the hypothesis whether or not dobutamine or dopamine infusion
increases gastric mucosal perfusion, a prospective randomized crossove
r trial was conducted on 10 septic patients in the intensive care unit
of a university hospital. Systemic hemodynamic, oxygen transport, and
gastric perfusion assessed by gastric intramucosal pH and laser Doppl
er flowmetry were measured at baseline and after administration of dob
utamine or dopamine (5 mu g/kg/min). Both increased oxygen transport I
n response to dobutamine, gastric mucosal blood flow increased (+32 +/
- 14% from baseline; p < 0.05), gastric tonometered PCO2 and gastric a
rterial PCO2 difference decreased (58 +/- 7 versus 52 +/- 7 mm Hg; p <
0.05; 16.8 +/- 7.0 versus 10.5 +/- 7.2 mm Hg; p < 0.05), and intramuc
osal pH increased (7.23 +/- 0.05 versus 7.29 +/- 0.06; p < 0.05), In r
esponse to dopamine, gastric mucosal blood flow decreased (-28 +/- 8%
from baseline; p < 0.05), gastric tonometered PCO2, gastric-arterial P
CO2 difference, and calculated intramucosal pH were unchanged (58 +/-
7 versus 61 +/- 9 mm Hg, ns; 16.8 +/- 7.0 versus 18.9 +/- 8.4 mm Hg, n
s; 7.24 +/- 0.05 versus 7.21 +/- 0.06, ns). We speculated that despite
an oxygen transport increase, dobutamine and dopamine have affected d
ifferently gastric mucosal perfusion in septic patients.