Haemodynamic effects of different doses of dopexamine hydrochloride in low cardiac output states following cardiac surgery.
We studied the haemodynamic effects of dopexamine hydrochloride, a beta 2-adrenergic agonist with dopaminergic (DA1) activity, in 20 patients with low cardiac output following surgery for coronary artery bypass grafting and/or valve replacement or repair. Following titration of four doses (1, 2, 4 and 6 micrograms.kg-1.min-1), the dose producing the optimal response was infused for up to 48 h (five patients). During the infusion, significant increases in cardiac index and stroke volume were accompanied by significant decreases in systemic vascular resistance. Heart rate increased significantly up to 6 h and thereafter returned to control levels. Mean blood pressure was reduced but did not fall below 60 mmHg. However, in five patients treated for 48 h mean blood pressure had returned to control levels. Unwanted effects (tachycardia and hypotension) were seen chiefly at higher doses, leading us to conclude that infusion rates of 4 micrograms.kg-1.min-1 or less will be useful in the treatment of low cardiac output following cardiac surgery.
German Heart Institute Berlin.
N
N
Friedel
R
R
Wenzel
G
G
Matheis
H
H
Kuppe
H
H
Bittner
S
S
Filcek
R
R
Hetzer
D000322:Adrenergic Agonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D002303:Cardiac Output, Low / Q000188:drug therapy*; D001026:Coronary Artery Bypass; D004298:Dopamine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy*
D000322:Adrenergic Agonists; C046318:dopexamine; D004298:Dopamine