Correction of splanchnic oxygen deficit in the intensive care unit: dopexamine and colloid versus placebo.
Correction of the splanchnic oxygen deficit indicated by low gastric intramucosal pH (pHi < 7.35) appears to reduce ICU mortality. Dopexamine hydrochloride is in clinical use for this purpose but its efficacy has not been fully investigated. We report the results of a prospective, randomized, placebo-controlled study with a crossover design to assess the efficacy of dopexamine in correcting low pHi. Twelve patients in whom pHi < 7.32 was detected during eight-hourly monitoring were randomized to receive either incremental dopexamine (4-6 micrograms/kg/min) with colloid or 5% dextrose for three hours prior to crossover. There was no difference in pHi between treatments despite cardiovascular effects during dopexamine infusion. There was, however, a time-related increase in pHi suggesting a beneficial effect of conventional therapy. Dopexamine hydrochloride at 4-6 micrograms/kg/min in conjunction with colloid is not a clinically useful therapy to correct the splanchnic oxygen deficit indicated by low pHi.
Trinder
T J
TJ
Royal Victorian Hospital, Belfast, N. Ireland.
Lavery
G G
GG
Fee
J P
JP
Lowry
K G
KG
D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D003102:Colloids / Q000627:therapeutic use*; D003422:Critical Care; D018592:Cross-Over Studies; D004298:Dopamine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007362:Intensive Care Units; D007511:Ischemia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010919:Placebos; D011446:Prospective Studies; D013152:Splanchnic Circulation / Q000187:drug effects*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000318:Adrenergic beta-Agonists; D003102:Colloids; D018491:Dopamine Agonists; D010919:Placebos; D014665:Vasodilator Agents; C046318:dopexamine; D004298:Dopamine