"Renal dose" dopamine is associated with the risk of new-onset atrial fibrillation after cardiac surgery.
OBJECTIVE
"Renal dose" dopamine (rDA; 1-3 microg/kg per min) is administered to patients after cardiac surgery to preserve or improve renal function. Many of these patients develop new-onset postoperative atrial fibrillation or atrial flutter (pAF) that could be related to rDA administration. The objective of this investigation was to determine whether there was an association between rDA and new-onset pAF in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass (CABG).


METHODS
Research hospital.


METHODS
The study population consisted of 1,731 patients undergoing CABG.


METHODS
CABG with and without rDA.


METHODS
After approval by the institutional review board, a retrospective study using the Cardiothoracic Anesthesia Patient Registry was undertaken to determine the association between rDA and pAF in patients undergoing CABG. Patients with a documented history of atrial fibrillation, those who required inotrope use during or after surgery, and those having valve surgery were excluded.


RESULTS
One-thousand seven-hundred thirty-one patients undergoing CABG during the period of January 1, 2000, through June 30, 2002, were the study population; of these, 15.0% (260/1,731) developed pAF. The incidence of pAF was 23.3 % (41/176) among patients who received rDA and 14.1% (219/1,555) among those who did not receive rDA. In the multivariable logistic regression model, patient age, gender, chronic obstructive pulmonary disease or asthma, and rDA were associated with pAF (p < .01). Receipt of rDA increased the odds of developing pAF by 74%, independent of the effect of other variables.


CONCLUSIONS
Renal-dose dopamine is associated with a 1.74 odds ratio of pAF developing after CABG.
Argalious
Maged
M
Department of General Anesthesiology, The Cleveland Clinic Foundation, Cleveland OH 44195, USA.
Motta
Pablo
P
Khandwala
Farah
F
Samuel
Samuel
S
Koch
Colleen Gorman
CG
Gillinov
A Marc
AM
Yared
Jean-Pierre
JP
Starr
Norman J
NJ
Bashour
C Allen
CA
D001281:Atrial Fibrillation / Q000139:chemically induced* / Q000453:epidemiology; D001282:Atrial Flutter / Q000139:chemically induced / Q000453:epidemiology; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D004298:Dopamine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009820:Ohio / Q000453:epidemiology; D011183:Postoperative Complications / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors
D004298:Dopamine