Influence of dobutamine on the variables of systemic haemodynamics, metabolism, and intestinal perfusion after cardiopulmonary resuscitation in the rat.
BACKGROUND
Global left ventricular dysfunction after successful resuscitation from cardiac arrest may be treated successfully with dobutamine but the effects on intestinal perfusion are unknown.


METHODS
In 24 male Sprague-Dawley rats ventricular fibrillation was induced. After 4 min of untreated cardiac arrest, precordial chest compression was performed for 4 min; adrenaline (epinephrine) (90 microg kg(-1)) was injected, followed by defibrillation. Return of spontaneous circulation was achieved in 18 animals, which were allocated to receive saline 0.9% (control group, n = 6), dobutamine at 5 microg kg(-1) min(-1) (n = 6) or dobutamine at 10 microg kg(-1) min(-1) (n = 6). Measurements of haemodynamic variables and intestinal tonometer P(CO2) were made before induction of ventricular fibrillation and 15, 30, 60, and 120 min postresuscitation.


RESULTS
At 120 min postresuscitation, mean aortic pressure was 82 +/- 20, 104 +/- 19, and 113 +/- 15 mmHg for the control group, the dobutamine (5 microg kg(-1) min(-1)) group and the dobutamine (10 microg kg(-1) min(-1)) group (P < 0.05 for comparison of the dobutamine (10 microg kg(-1) min(-1)) group versus the control group). Respective abdominal aortic blood flow was 107 +/- 16, 133 +/- 49, and 145 +/- 18 ml min(-1) kg(-1) (P < 0.05 for comparison of the dobutamine (10 microg kg(-1) min(-1)) group versus the control group), and superior mesenteric artery blood flow was 25 +/- 9, 28 +/- 8, and 33 +/- 8 ml min(-1) kg(-1). Arterial lactate was significantly higher (P < 0.05) in the control group (2.3 +/- 0.6 mmol l(-1)) than in the dobutamine (5 microg kg(-1) min(-1)) group (1.6 +/- 0.3 mmol l(-1)) and dobutamine (10 microg kg(-1) min(-1)) group (1.5 +/- 0.3 mmol l(-1)). Tonometrically derived P(CO2) gap was highly elevated at 15 min of postresuscitation and returned to prearrest level at 120 min postresuscitation in all groups.


CONCLUSIONS
Dobutamine enhances the recovery of global haemodynamic and metabolic variables early after cardiac arrest.
Studer
Wolfgang
W
Department of Anaesthesiology and Research, University of Basel, CH-4031 Basel, Switzerland. wolfgang.studer@bluewin.ch
Wu
Xianren
X
Siegemund
Martin
M
Marsch
Stephan
S
Seeberger
Manfred
M
Filipovic
Miodrag
M
D000818:Animals; D016887:Cardiopulmonary Resuscitation; D002316:Cardiotonic Agents / Q000494:pharmacology*; D004195:Disease Models, Animal; D004280:Dobutamine / Q000494:pharmacology*; D006323:Heart Arrest / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D006439:Hemodynamics / Q000187:drug effects*; D007422:Intestines / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008660:Metabolism / Q000187:drug effects; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000187:drug effects; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function; D012016:Reference Values; D014693:Ventricular Fibrillation / Q000150:complications / Q000503:physiopathology
D002316:Cardiotonic Agents; D004280:Dobutamine