Dobutamine and gastric-to-arterial carbon dioxide gap in severe sepsis without shock

Intensive Care Medicine
Gilles LebuffeBenoît Vallet

Abstract

To evaluate the effect of an early dobutamine infusion on gastrointestinal perfusion in patients with severe sepsis. Prospective, randomized, controlled, multicenter clinical study. Six medical and/or surgical intensive care units (ICU) of teaching hospitals. Forty-two patients with severe sepsis. Patients were divided into two groups according to gastric-to-arterial CO2 gap (DeltaCO2) [normal DeltaCO2 group ( n=17): DeltaCO2 < or = 8 mmHg; increased DeltaCO2 group ( n=25): DeltaCO2 > 8 mmHg]. Patients within each group were then randomized to receive either dobutamine (5 microg/kg per min) or saline for 72 h. SAPS II was similar in both groups [group 1: 44.0 (33.0-56.5); group 2: 48.5 (40.5-59.0), p=0.27]. At ICU admission, mean arterial pressure was lower in the high DeltaCO2 group [73.0 (67.0-79.5) mmHg, p=0.03] than in the normal DeltaCO2 group [84.0 (73.7-104.0) mmHg] while blood lactate [normal DeltaCO2 group: 1.6 (0.8-2.3); high DeltaCO2 group: 1.6 (1.1-1.9) mmol/l] was similar for the two groups. DeltaCO2 was significantly lower in the normal DeltaCO2 group [5.0 (2.0-6.0) mmHg)] than in the high DeltaCO2 group [11.0 (10.0-19.0) mmHg]. Dobutamine infusion did not significantly change hemodynamics, blood lactate concentra...Continue Reading

Citations

Aug 27, 2009·Internal and Emergency Medicine·Andrea NencioniNathan I Shapiro
Apr 12, 2003·Current Opinion in Pulmonary Medicine·Sat Sharma, Anand Kumar
Sep 3, 2004·Critical Care Medicine·Steven M HollenbergSergio Zanotti-Cavazzoni
Dec 25, 2010·Critical Care : the Official Journal of the Critical Care Forum·Andrea MorelliMartin Westphal
Apr 7, 2005·Intensive Care Medicine·Andrea MorelliPaolo Pietropaoli
Nov 26, 2008·Acta histochemica·Koray ErbüyünIdil Tekin
Jun 18, 2005·Anaesthesia·M WeissP Hasenclever
Oct 23, 2012·Journal of Critical Care·Carolina EnricoArnaldo Dubin
May 6, 2014·Journal of Critical Care·Elio AntonucciSabino Scolletta
Oct 3, 2002·Current Opinion in Critical Care·Curtis N Sessler, Wes Shepherd

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