CORRECTION OF SPLANCHNIC OXYGEN DEFICIT IN THE INTENSIVE-CARE UNIT - DOPEXAMINE AND COLLOID VERSUS PLACEBO

Correction of the splanchnic oxygen deficit indicated by low gastric i ntramucosal pH(pH(i) < 7.35) appears to reduce ICU mortality. Dopexami ne hydrochloride is in clinical use for this purpose but its efficacy has not been fully investigated. We report the results of a prospectiv e, randomized, placebo-controlled study with a crossover design to ass ess the efficacy of dopexamine in correcting low pH(i), Twelve patient s in whom pH(i) < 7.32 was detected during eight-hourly monitoring wer e randomized to receive either incremental dopexamine (4-6 mu g/kg/min ) with colloid or 5% dextrose for three hours prior to crossover. Ther e was no difference in pH(i) between treatments despite cardiovascular effects during dopexamine infusion. There was, however, a time-relate d increase in pH(i) suggesting a beneficial effect of conventional the rapy. Dopexamine hydrochloride at 4-6 mu g/kg/min in conjunction with colloid is not a clinically useful therapy to correct the splanchnic o xygen deficit indicated by low pH(i).