Administration of low-dose dopamine to nonoliguric patients with sepsis syndrome does not raise intramucosal gastric pH nor improve creatinine clearance

American Journal of Respiratory and Critical Care Medicine
D OlsonJ B Hall

Abstract

Tissue hypoxia resulting from regional blood flow abnormalities and oxygen extraction defects may underlie the pathogenesis of multiple system organ failure (MSOF) in sepsis. Low-dose dopamine (LDD) is widely employed to enhance splanchnic perfusion although data to support this approach are lacking. We assessed the effect of LDD on surrogate markers of renal and gastric perfusion. Sixteen nonoliguric mechanically ventilated patients with sepsis syndrome received LDD (3 micrograms/kg/min) or placebo in a double-blind crossover design experiment. Hemodynamics, gastric intramucosal pH (pHi) urine volumes, urinary sodium excretion, and cimetidine-corrected creatinine clearance were compared. Mortality for the group was 63%. LDD caused a significant increase in urine volume (88 +/- 58 to 115 +/- 70 ml/h, p = 0.02, 95% confidence interval for change 4.7 to 49 ml/h), but no significant change in any other parameter. We conclude that use of LDD results in diuresis but does not improve other markers of renal or gut perfusion. These data do not support the use of LDD to reduce risk of progression to MSOF in sepsis.

Citations

Nov 15, 2005·Der Anaesthesist·A BauerF Christ
May 26, 1999·Infectious Disease Clinics of North America·R P Dellinger
Oct 22, 1998·Critical Care Medicine·E SilvaJ L Vincent
Mar 13, 1999·Critical Care Medicine·P E Marik
Nov 5, 1999·Critical Care Medicine·P E Marik, M T Haupt
Aug 16, 2001·Critical Care Medicine·J A Kellum, J M Decker
Aug 16, 2001·Critical Care Medicine·M I Rudis
Mar 13, 2002·Critical Care Medicine·Jürgen GrafWilliam J Sibbald
Jun 2, 2005·Current Opinion in Critical Care·Paul E Marik
May 22, 2004·Critical Care : the Official Journal of the Critical Care Forum·Pierre AsfarSamir G Sakka
Jan 27, 2004·Anesthesia and Analgesia·Yves A Debaveye, Greet H Van den Berghe
Feb 6, 2004·Best Practice & Research. Clinical Anaesthesiology·Raymond Wai Chuen LeeRinaldo Bellomo
Jan 10, 2006·Critical Care Clinics·Pierre AsfarMartin Matejovic
Aug 22, 2009·Emergency Medicine Australasia : EMA·Ainslie Senz, Leo Nunnink
Oct 19, 2006·The Journal of Emergency Medicine·Murugan Raghavan, Paul E Marik
Jul 18, 2001·Journal of Applied Physiology·J A GuzmanJ A Kruse
Oct 20, 2001·Disease-a-month : DM·P E Marik, J Varon
Apr 10, 2003·Chest·Cheryl L Holmes, Keith R Walley

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