Effect of dopamine and metaraminol on the renal function of patients with septic shock.
BACKGROUND
Vasoactive drugs are often necessary for reversing hypotension in patients with severe infection. The standard for evaluating effects of vasoactive drugs should not only be based on the increase of arterial blood pressure, but also on the blood flow perfusion of internal organs. The effects of dopamine and metaraminol on the renal function of the patients with septic shock were investigated retrospectively in this study.


METHODS
Ninety-eight patients with septic shock were divided into three groups according to the highest infusing rate of metaraminol, with the lightest infusing rate of (0.1 - 0.5, 0.6 - 1.0, > 1.0) microgxkg(-1)xmin(-1) in group A, B and C respectively. Urine output, mean arterial blood pressure (MAP), heart rate (HR), urine output, blood urea nitrogen (BUN), creatinine (CRE), urine albumin (U-ALB), urine beta(2)-microglubulin (Ubeta(2)-MG) and Apache III scores were recorded.


RESULTS
Before antishock therapy, hypotension, tachycardia and oliguria occurred to all the 98 patients with septic shock and CRE, BUN, U-ALB, Ubeta(2)-MG and Apache III scoring were abnormal in most cases. With the antishock therapy, MAP, HR, urine output, BUN and CRE in all patients returned gradually to normal (P < 0.05 or < 0.01 compared to those before antishock therapy). U-ALB, Ubeta(2)-MG output and Apache III scoring also reverted but remained abnormal (P < 0.01 compared to those before antishock therapy). No statistically significant differences in the changes of these indices with the time existed among the three groups (P > 0.05).


CONCLUSIONS
Dopamine and metaraminol when applied to the patients with septic shock could effectively maintain the circulatory stability and promote restoration of renal function.
Hou
Li-Chao
LC
Department of Anaesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Li
Shu-Zhi
SZ
Xiong
Li-Ze
LZ
Chen
Shao-Yang
SY
Chen
Min
M
Zhang
Xi-Jing
XJ
Huo
Ting-Ting
TT
Wang
Qiang
Q
Wang
Ya-Li
YL
Hu
Wen-Neng
WN
D018806:APACHE; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D001806:Blood Urea Nitrogen; D004298:Dopamine / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008680:Metaraminol / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D012772:Shock, Septic / Q000188:drug therapy* / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D001613:beta 2-Microglobulin / Q000652:urine
D014662:Vasoconstrictor Agents; D001613:beta 2-Microglobulin; D008680:Metaraminol; D004298:Dopamine