DOBUTAMINE IN CRITICALLY ILL PATIENTS - DISCREPANCIES BETWEEN HEMODYNAMIC PARAMETERS OF TISSUE OXYGENATION AND ARTERIAL LACTIC-ACID LEVELS

A retrospective study on the effects of dobutamine on hemodynamic para meters of tissue oxygenation and lactic acid levels was performed in 3 5 patients. The use of the drug in a mean dose of 5.0 +/- 2.1 ug/kg/mi n was associated with a significant increase in cardiac index oxygen t ransport and consumption and decrease in arterial lactic acid levels. A separate analysis of patients with or without basal hyperlactacidemi a and those with favorable (decrease) or unfavorable (no change or inc rease) lactic acid response to the drug, was performed. This analysis disclosed important disagreements between changes in hemodynamic param eters of oxygen consumption and transport and arterial lactic acid lev els, as indexes of tissue perfusion. It is concluded that is advisable to monitor together hemodynamics, oxygen transport and consumption an d arterial lactic acid in patients with severe cardiorespiratory distu rbances or shock.