title: Is dopexamine superior to dopamine in the treatment of multiple trauma patients--a prospective, double-blind, randomised study.
abstract: BACKGROUND
  The goal of this prospective, randomised, double-blind clinical trial study was to assess the effects of dopexamine hydrochloride on organ failure, inflammatory mediators and splanchnic oxygenation in blunt multiple trauma patients at high risk of multiple organ dysfunction syndrome (MODS).
  
  
  METHODS
  We performed a prospective randomised controlled trial on 30 consecutive blunt multiple trauma patients with ISS>or=16, age 18-60 years and initial blood pressure >or=120 mmHg initially admitted to our level I trauma centre. Patients were randomised to treatment with dopamine (n=15) or dopexamine (n=15) for 48 h after admission. Outcome in terms of mortality, MODS, splanchnic perfusion, complications, duration of stay was statistically analysed.
  
  
  RESULTS
  Dopexamine treatment was associated with impaired organ function and an increased duration of ventilation and ICU stay compared with patients who received dopamine treatment. The acute inflammatory response was increased in the Dopexamine group while a decreased pHi and MEGX formation and increased serum lactate levels were measured.
  
  
  CONCLUSIONS
  The indication to use dopexamine hydrochloride appears questionable. In the absence of an antiinflammatory effect, dopexamine demonstrated a disadvantageous ICU course in regards to the organ function and the duration of treatment. In addition, a decreased pHi and MEGX formation suggested a deterioration of splanchnic oxygenation.
authors: Department of Trauma Surgery, Hannover Medical School, 30623 Hannover, Germany. probst.christian@mh-hannover.de
authors: Christian
authors: C
authors: Probst
authors: Frank
authors: F
authors: Hildebrand
authors: Martijn
authors: M
authors: van Griensven
authors: Hellmut
authors: H
authors: Baur
authors: Lutz
authors: L
authors: Mahlke
authors: Christian
authors: C
authors: Krettek
authors: Hans-Christoph
authors: HC
authors: Pape
authors: Martin Rolf Wolfgang
authors: MR
authors: Grotz
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D003422:Critical Care; D004298:Dopamine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D007902:Length of Stay; D008012:Lidocaine / Q000031:analogs & derivatives / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D009104:Multiple Trauma / Q000150:complications* / Q000378:metabolism / Q000401:mortality; D010101:Oxygen Consumption / Q000187:drug effects; D011446:Prospective Studies; D012121:Respiration, Artificial; D013152:Splanchnic Circulation / Q000187:drug effects; D015599:Trauma Severity Indices; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014781:Viscera / Q000098:blood supply*; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000378:metabolism / Q000401:mortality; D055815:Young Adult
chemical_list: D014665:Vasodilator Agents; C046318:dopexamine; D008012:Lidocaine; C001173:monoethylglycinexylidide; D004298:Dopamine