A comparison of the effects of dopexamine prostacyclin in systemic inflammatory response syndrome

Forty critically ill patients fulfilling the definitions of systemic inflam matory response syndrome were enrolled in a double-blind cross-over interve ntional study assessing the effects of dopexamine and prostacyclin on splan chnic perfusion, cardiovascular function and oxygen flux. The cross-over de sign involved either dopexamine (1.25 mu g.kg(-1).min(-1)) or prostacyclin (0.5 ng.kg(-1).min(-1)) being infused for 6 h followed by a 12-h washout pe riod prior to an identical infusion sequence using the other agent. Prelimi nary analysis revealed a significant period effect, so data from the second infusion period were excluded from further analysis. Dopexamine caused a s ignificant increase in heart rate (116 vs. 106 beat.min(-1)), and urine out put (103 vs. 69 ml.h(-1)). Dopexamine produced a significant increase in ox ygen delivery (infusion 548 ml O-2.min(-1).m(-2); no infusion 492 ml O-2.mi n(-1).m(-2)) while prostacyclin caused a decrease (infusion 460 ml O-2.min( -1).m(-2); no infusion 547 ml O-2.min(-1).m(-2)). The results indicate that dopexamine improves oxygen delivery and urine output more effectively than prostacyclin.