A comparison of the effects of dopexamine and prostacyclin in systemic inflammatory response syndrome.
Forty critically ill patients fulfilling the definitions of systemic inflammatory response syndrome were enrolled in a double-blind cross-over interventional study assessing the effects of dopexamine and prostacyclin on splanchnic perfusion, cardiovascular function and oxygen flux. The cross-over design involved either dopexamine (1.25 micrograms.kg-1.min-1) or prostacyclin (0.5 ng.kg-1.min-1) being infused for 6 h followed by a 12-h washout period prior to an identical infusion sequence using the other agent. Preliminary analysis revealed a significant period effect, so data from the second infusion period were excluded from further analysis. Dopexamine caused a significant increase in heart rate (116 vs. 106 beat.min-1), and urine output (103 vs. 69 ml.h-1). Dopexamine produced a significant increase in oxygen delivery (infusion 548 ml O2.min-1.m-2; no infusion 492 ml O2.min-1.m-2) while prostacyclin caused a decrease (infusion 460 ml O2.min-1.m-2; no infusion 547 ml O2.min-1.m-2). The results indicate that dopexamine improves oxygen delivery and urine output more effectively than prostacyclin.
Blunt
M
M
Norfolk & Nonvich Hospital, UK.
Young
P
P
Ridley
S
S
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018592:Cross-Over Studies; D004298:Dopamine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004311:Double-Blind Method; D011464:Epoprostenol / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013152:Splanchnic Circulation / Q000187:drug effects; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000318:Adrenergic beta-Agonists; D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; C046318:dopexamine; D011464:Epoprostenol; D004298:Dopamine