RETRACTED: Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery (Retracted Article)

被引:12
作者
Boldt, J
Papsdorf, M
Piper, S
Padberg, W
Hempelmann, G
机构
[1] Klinikum Stadt Ludwigshafen, Dept Anaesthesiol & Intens Care Med, D-67063 Ludwigshafen, Germany
[2] Univ Giessen, Dept Anaesthesiol & Intens Care Med, Giessen, Germany
[3] Univ Giessen, Dept Surg, Giessen, Germany
关键词
surgery; abdominal; hemodynamics; oxygen transport; microcirculation; organ perfusion; dopexamine; vasopressin; endothelin; atrial natriuretic peptide; catecholamines;
D O I
10.1111/j.1399-6576.1998.tb05354.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 mu g . kg(-1) . min(-1) of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-l (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61+/-0.41 to 4.57+/-0.78 I . min(-1) . m(-2)) and remained elevated until the morning of the first postoperative day. Oxygen delivery index ((D) over dot O2I) and oxygen consumption index ((V) over dot O2I) were also significantly increased in the dopexamine group ((D) over dot O2I: from 416+/-91 to 717+/-10 ml/m(2) . m(2); (V) over dot O2I: from 98+/-25 to 157+/-22 ml/m2 m2), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37+/-2.1 to 35.9+/-12.1 pg/ml; ET-1: from 2.88+/-0.91 to 6.92+/-1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.
引用
收藏
页码:941 / 947
页数:7
相关论文
共 27 条
[1]  
ANGGARD EE, 1990, BLOOD VESSELS, V27, P269
[2]   CHANGES IN REGIONAL BLOOD-FLOW DISTRIBUTION INDUCED BY INFUSIONS OF DOPEXAMINE HYDROCHLORIDE OR DOBUTAMINE IN ANESTHETIZED DOGS [J].
BIRO, GP ;
DOUGLAS, JR ;
KEON, WJ ;
TAICHMAN, GC .
AMERICAN JOURNAL OF CARDIOLOGY, 1988, 62 (05) :C30-C36
[3]   REGIONAL BLOOD-FLOW EFFECTS OF DOPEXAMINE VERSUS ENALAPRILAT DURING PROPOFOL ANESTHESIA IN RABBITS WITH EXPERIMENTAL CHRONIC HEART-FAILURE [J].
BLAKE, DW ;
WAY, D ;
TRIGG, L ;
MCGRATH, BP .
CARDIOVASCULAR RESEARCH, 1994, 28 (05) :710-714
[4]   A RANDOMIZED CLINICAL-TRIAL OF THE EFFECT OF DELIBERATE PERIOPERATIVE INCREASE OF OXYGEN DELIVERY ON MORTALITY IN HIGH-RISK SURGICAL PATIENTS [J].
BOYD, O ;
GROUNDS, RM ;
BENNETT, ED .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 270 (22) :2699-2707
[5]   ENDOTHELIUM-DEPENDENT VASCULAR-RESPONSES - MEDIATORS AND MECHANISMS [J].
BRENNER, BM ;
TROY, JL ;
BALLERMANN, BJ .
JOURNAL OF CLINICAL INVESTIGATION, 1989, 84 (05) :1373-1378
[6]   DOPEXAMINE - A NOVEL AGONIST AT PERIPHERAL DOPAMINE-RECEPTORS AND BETA-2-ADRENOCEPTORS [J].
BROWN, RA ;
DIXON, J ;
FARMER, JB ;
HALL, JC ;
HUMPHRIES, RG ;
INCE, F ;
OCONNOR, SE ;
SIMPSON, WT ;
SMITH, GW .
BRITISH JOURNAL OF PHARMACOLOGY, 1985, 85 (03) :599-608
[7]   PROTECTIVE EFFECTS OF DOPEXAMINE HYDROCHLORIDE IN RENAL-FAILURE AFTER ACUTE HEMORRHAGE IN ANESTHETIZED DOGS [J].
CHINTALA, MS ;
LOKHANDWALA, MF ;
JANDHYALA, BS .
JOURNAL OF AUTONOMIC PHARMACOLOGY, 1990, 10 :S95-S102
[8]   ASSOCIATIONS BETWEEN INTRAMUCOSAL ACIDOSIS IN THE GUT AND ORGAN FAILURE [J].
FIDDIANGREEN, RG .
CRITICAL CARE MEDICINE, 1993, 21 (02) :S103-S107
[9]   DOPEXAMINE HYDROCHLORIDE - A REVIEW OF ITS PHARMACODYNAMIC AND PHARMACOKINETIC PROPERTIES AND THERAPEUTIC POTENTIAL IN ACUTE CARDIAC-INSUFFICIENCY [J].
FITTON, A ;
BENFIELD, P .
DRUGS, 1990, 39 (02) :308-330
[10]  
FLEZZANI P, 1988, J CARDIOTHORAC ANEST, V3, P274