Effects of fenoldopam mesylate on central hemodynamics and renal flow in patients undergoing cardiac surgery: color Doppler echocardiographic evaluation.
OBJECTIVE
The purpose of this study was to evaluate the effect of 0.1 microg/kg/min of fenoldopam mesylate on renal flow and central hemodynamics measured by echocardiography in hemodynamically stable patients with preserved renal function undergoing cardiac surgery.


METHODS
Experimental observational study.


METHODS
Single-institutional community hospital study.


METHODS
Thirty patients undergoing cardiac surgery.


METHODS
Fenoldopam mesylate infusion (0.1 microg/kg/min) in patients undergoing cardiopulmonary bypass.


RESULTS
Doppler measurements of renal blood flow and echocardiographic hemodynamic determinations after Doppler echocardiography measured flux velocities of the main, segmental, and interlobar and interlobular right renal arteries. The authors calculated the resistive index of all the renal segments studied. Moreover, the authors measured the flux of the main renal artery and its diameter as well as the main hemodynamic variables. All the measurements were performed in the intensive care unit setting at baseline and 20 minutes after the infusion of 0.1 microg/kg/min of fenoldopam mesylate. Fenoldopam mesylate infusion significantly increased blood flow in all renal compartments, thus improving the resistive index. The study showed that fenoldopam mesylate infusion does not induce any significant change of the heart rate or arterial pressure, cardiac output, preload, or wall stress.


CONCLUSIONS
In hemodynamically stable cardiac surgery patients with preserved renal function, an infusion of 0.1 microg/kg/min of fenoldopam mesylate has no influence on systemic hemodynamics while increasing renal blood flow.
Meco
Massimo
M
Cardiac Surgery and Anesthesia and Intensive Care Department, Instituto Clinico Sant'Ambrogio, Via Faravelli 16, 20171 Milan, Italy. massimo.meco@virgilio.it
Cirri
Silvia
S
D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D018491:Dopamine Agonists / Q000008:administration & dosage* / Q000494:pharmacology; D018618:Echocardiography, Doppler, Color; D005260:Female; D018818:Fenoldopam / Q000008:administration & dosage* / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D008297:Male; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000502:physiology; D012079:Renal Circulation / Q000187:drug effects / Q000502:physiology
D018491:Dopamine Agonists; D018818:Fenoldopam