[Acute effect of dobutamine and amrinone on hemodynamics and splanchnic perfusion in septic shock patients]

Vasoactive drugs used in the reanimation of septic patients, can modify splanchnic perfusion.

To compare the effects of dobutamine and amrinone on gastric intramucosal pH (pHi), lactate levels and hemodynamics in surgical patients with compensated septic shock.

Fourteen postoperative patients with abdominal sepsis and compensated septic shock (pHi < 7.32 or lactate > 2.5 mmol/l) were studied in a prospective, randomized, unblinded study. Patients were randomized to receive (Group 1, n = 7) dobutamine at 5 micrograms/Kg/min or (Group 2, n = 7) amrinone at 5 micrograms/Kg/min. Hemodynamic data, arterial lactate and pHi were measured before and 30, 60 and 120 minutes after starting drug infusion.

Both drugs were associated with a decrease in lactate levels. Dobutamine infusion, but not amrinone, increased gastric pHi, as well as cardiac index and oxygen delivery.

An improvement in gastric pHi associated with an increase in oxygen delivery, was observed with dobutamine. Amrinone showed no effect at the fixed, low dose used in the study.