Effect of dopexamine on hepatic metabolic activity in patients with septic shock

被引：11

作者：

Kiefer, P ^{[1
]}

Tugtekin, I ^{[1
]}

Wiedeck, H ^{[1
]}

Vogt, J ^{[1
]}

Wachter, U ^{[1
]}

Bracht, H ^{[1
]}

Geldner, G ^{[1
]}

Georgieff, M ^{[1
]}

Radermacher, P ^{[1
]}

机构：

[1] Univ Ulm Klinikum, Dept Anesthesiol, D-89075 Ulm, Germany

来源：

SHOCK | 2001年 / 15卷 / 06期

关键词：

catecholamines; endogenous glucose production; hepato-splanchnic metabolic rate;

D O I：

10.1097/00024382-200115060-00003

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Hepato-splanchnic metabolic activity is seen to be related to regional blood flow and oxygen/substrate availability in patients with sepsis. Catecholamines, which may modulate metabolic activity per se, are common to stabilize hemodynamics. We studied the effect of a dopexamine-induced increase in splanchnic blood flow (Qspl) on regional metabolic rate in 10 patients with septic shock requiring norepinephrine to maintain mean arterial pressure (>60 mmHg). Splanchnic blood flow was determined using the indocyanine-green method with hepatic venous sampling. We determined the hepato-splanchnic lactate, pyruvate, alanine, and glutamine turnover and the lactate/pyruvate and ketone body ratio as well as the endogenous glucose production (EGP) using the stable isotope approach. Qspl increased from 0.86 (0.79-1.15) to 0.96 (0.92-1.33) L/min/m(2), not influencing any parameter of metabolic activity. We speculate that this finding is due to altered beta -adrenoreceptor-mediated thermogenic effects due to the interplay of different beta -sympathomimetics at the receptor site.

引用

页码：427 / 431

页数：5