Oral administration of the dopamine prodrug docarpamine shortens need for drip infusion of dopamine in patients with low cardiac output syndrome after cardiac surgery

Background: Docarpamine (DOC) is a dopamine prodrug which can be orally adm inistered. It has been found that oral docarpamine transforms into dopamine in vivo, and increases cardiac output and renal blood flow as effectively as intravenous dopamine. Methods: We reviewed the records of 26 patients wh o had developed low cardiac output syndrome (LOS) after cardiac surgery and received docarpamine during the early postoperative course. Five patients discontinued docarpamine within 2 days due to arrhythmia. There were 3 hosp ital deaths. The remaining 18 patients were divided into two groups accordi ng to the timing of docarpamine administration. In group A docarpamine was administered during and after weaning from intravenous catecholamines, in g roup B only on demand after weaning from intravenous catecholamines. Result s: There were 12 patients in group A and 6 in group B, and the severity of LOS was relatively milder in group B than in group A. Stable hemodynamics a nd sufficient daily urinary output were maintained by oral administration o f DOC in both groups just as well as by drip infusion of catecholamines. Co nclusion: Sinse continuous drip infusion of catecholamine commonly slows re covery in LOS patients, it is considered that switching from drip infusion of catecholamines to oral DOC administration is safe and useful for earlier recovery in LOS patients after cardiac surgery.