title: [Low-doses dobutamine and fluids in high-risk surgical patients: effects on tissue oxygenation, inflammatory response and morbidity].
abstract: OBJECTIVE
  Dobutamine is an inotropic agent with predominant beta1- adrenergic properties frequently used to increase blood flow in critically ill patients. Dobutamine may have a role in increasing splanchnic perfusion, thereby protecting this area from further injury. We investigated the effects of low doses dobutamine (5 mug/kg/min) on tissue oxygenation, inflammatory response and postoperative complications in high-risk surgical patients.
  
  
  METHODS
  Prospective, randomized, blinded and placebo-controlled study. One hundred surgical patients admitted in a step-down unit were evaluated and 82 patients were enrolled, 42 in the control group (saline) and 40 in the treatment group (5 mug/kg/h) during 24 hours. Similar therapeutic goals were applied to both groups. Fluids were given whenever tachycardia or hypotension developed after study drug infusion.
  
  
  RESULTS
  The total volume of fluids given was significantly higher in treatment than in control group (7351 ± 2082 mL versus 6074 ± 2386 mL, respectively, p < 0.05). Central venous oxygen saturation (ScvO2), serum lactate and C-reactive protein were similar in both groups. Complications occurred in 35% and 50% of the patients in the treatment and control groups, respectively (RR 0, 70 IC 95% 0.41 - 1.17; NS).
  
  
  CONCLUSIONS
  Low-doses dobutamine and fluids after surgical trauma has no effects on the prevalence of postoperative complications in high-risk surgical patients.
authors.affiliation: Hospital de Base, FAMERP.
authors.forename: Adriana da Silva
authors.initials: Ada S
authors.lastname: Arantes
authors.affiliation: Serviço de Câmara Hiperbárica, Hospital de Base, FAMERP.
authors.forename: Antônio Carlos
authors.initials: AC
authors.lastname: Christiano Júnior
authors.affiliation: Unidade de Terapia Intensiva, Hospital de Base, FAMERP.
authors.forename: Sônia Portela de
authors.initials: SP
authors.lastname: Abreu
authors.affiliation: Medicina Intensiva, FAMERP.
authors.forename: Janaína Maria Miranda Ferreira de
authors.initials: JM
authors.lastname: Moraes
authors.affiliation: Serviço de Farmácia, Hospital de Base, FAMERP.
authors.forename: Joelma Villafanha
authors.initials: JV
authors.lastname: Gandolfi
authors.affiliation: Hospital de Base, FAMERP.
authors.forename: Lauriane Gomes
authors.initials: LG
authors.lastname: Leite
authors.affiliation: Clinica Médica, FAMERP.
authors.forename: Suzana Margareth
authors.initials: SM
authors.lastname: Lobo