FAILURE OF DOBUTAMINE TO IMPROVE LIVER OXYGENATION DURING RESUSCITATION WITH A CRYSTALLOID SOLUTION AFTER EXPERIMENTAL HEMORRHAGIC-SHOCK

Objective: To evaluate the effects of dobutamine on peripheral and hep atic tissue oxygen tensions during the treatment of haemorrhagic shock . Design: Randomised, controlled trial. Setting: University hospital, Finland. Subjects. 12 Piglets, weight 20 kg. Interventions: Haemorrhag ic shock (40% of blood volume removed) and resuscitation with crystall oid solution. Dobutamine infused (6.5 mu g/kg/min) during resuscitatio n in 6 animals and 6 served as controls. Main outcome measures: Haemod ynamic and systemic oxygen transport variables. Hepatic, subcutaneous, transcutaneous, and conjunctival oxygen tensions measured continuousl y with polarographic electrodes. Results: All values decreased signifi cantly during bleeding. Resuscitation restored the mean arterial press ure in both groups, and cardiac output exceeded the baseline by 24% in the dobutamine group (p < 0.05 compared with control). There was no d ifference in oxygen delivery and consequently tissue oxygen tensions r emained at the control level in the dobutamine group. Conclusions: Dob utamine infusion did not improve tissue oxygenation when used in addit ion to crystalloids to treat hypovolaemic shock.