Hemodynamics and renal function during administration of low-dose dopamine in severely ill patients.
BACKGROUND
Although a large number of studies have been performed regarding the renal and hemodynamic effects of the infusion of low-dose dopamine (LDD) in severely ill patients, there is still controversy on this subject.


OBJECTIVE
To evaluate the effects of dopamine (2 microg/kg/min) on systemic hemodynamics (lowest mean arterial pressure, MAP, highest heart rate, HR, central venous pressure, CVP), creatinine clearance (CLcr), diuresis and fractional sodium excretion (FENa+).


METHODS
A non-randomized, open, prospective clinical trial.


METHODS
An intensive care unit in a tertiary university hospital.


METHODS
22 patients with hemodynamic stability admitted to the intensive care unit.


METHODS
Patients were submitted to three two-hour periods: without dopamine (P1), with dopamine (P2) and without dopamine (P3).


METHODS
The above mentioned variables were measured during each period. CLcr was assessed based upon the formula U x V/P, where U is urinary creatinine (mg/dl), V is diuresis in ml/min and P is serum creatinine (mg/dl). FENa+ was calculated based upon the formula: urinary sodium (mEq/l) x P/plasma sodium (mEq/l) x U) x 100. Results were presented as mean and standard deviation. The Student t test was used and results were considered significant if p was less than 0.05.


RESULTS
Twelve patients (seven males and five females) were included, with a mean age of 55.45 years. There was no significant variation in MAP, HR, CVP, CLcr or FENa+ with a dopamine dose of 2 microg/kg/min. On the other hand, diuresis significantly increased during P2, from 225.4 to 333.9 ml.


CONCLUSIONS
Infusion of 2 microg/kg/min of dopamine for 2 hours increases diuresis. At the doses studied, dopamine does not induce significant alterations in MAP, HR, CVP, CLcr and FENa+.
Pereira
Cláudia Nathalie
CN
Intensive Care Unit, Discipline of Anesthesiology, Pain and Intensive Care, Universidade Federal de São Paulo, São Paulo, Brazil.
Machado
Flávia Ribeiro
FR
Guimarães
Hélio Penna
HP
Senna
Ana Paula Resque
AP
do Amaral
José Luiz Gomes
JL
D018806:APACHE; D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D003422:Critical Care; D004298:Dopamine / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012079:Renal Circulation
D002316:Cardiotonic Agents; D004298:Dopamine