Dopexamine, dobutamine, and dopamine increase splanchnic blood flow: what is the evidence?
Inadequate splanchnic perfusion in the critically ill compromises the gut barrier leading to bacterial translocation, which is postulated to cause multiorgan dysfunction and failure. Inotropic agents such as dopexamine, dobutamine, and dopamine may have a role in increasing splanchnic perfusion, thereby protecting this area from further injury. This article examines the evidence for using these agents in patients with sepsis, postoperative trauma, and in those undergoing cardiac surgery and mechanical ventilation to increase gut perfusion and prevent multiple organ failure. Systemic effects of these agents differ from regional effects and must be considered when selecting therapy.
Lisbon
Alan
A
Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. alisbon@caregroup.harvard.edu
D000318:Adrenergic beta-Agonists / Q000494:pharmacology*; D006348:Cardiac Surgical Procedures; D002316:Cardiotonic Agents / Q000494:pharmacology*; D004280:Dobutamine / Q000494:pharmacology*; D004298:Dopamine / Q000031:analogs & derivatives* / Q000494:pharmacology*; D019317:Evidence-Based Medicine; D006801:Humans; D013152:Splanchnic Circulation / Q000187:drug effects*; D014665:Vasodilator Agents / Q000494:pharmacology*
D000318:Adrenergic beta-Agonists; D002316:Cardiotonic Agents; D014665:Vasodilator Agents; C046318:dopexamine; D004280:Dobutamine; D004298:Dopamine