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Effects of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery
M Müller1, J Boldt, E Schindler
1Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen, Germany.
Objective:
To study the influence of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery.
Design:
Prospective, randomized, placebo-controlled study.
Setting:
University hospital.
Patients:
Eighteen adult patients undergoing elective major abdominal surgery.
Interventions:
The patients received either dopexamine at 1 microg/kg/min (group A, n = 9) or 0.90% saline as control (group B, n = 9).
Measurements And Results:
To assess the splanchnic oxygenation, intestinal tissue PO2 (PtissO2) and gastric intramucosal Pco2 (PmucCO2) were measured, and the PCO2 gap (PmucCO2 - PaCO2) was calculated at baseline (T1) and after an infusion period of 60 mins (T2). There was no difference between the groups in the global oxygen transport parameters. Low-dose dopexamine increases PtissO2 on the serosal side of the small bowel (deltaPtissO2, 17+/-24 mm Hg in group A vs. -5+/-10 in group B). The changes in PtissO2 at the serosal side of the colon after dopexamine demonstrated a nonsignificant increase (deltaPtissO2, 7+/-11 mm Hg in group A vs. -11+/-23 mm Hg in group B). In both groups, the Pco2 gap (group A, 6+/-7 mm Hg [T1] and 5+/-6 mm Hg [T2], vs. group B, 9+/-10 mm Hg [T1] and 12+/-10 mm Hg [T2]) remained unchanged compared with the baseline.
Conclusion:
It is concluded that low-dose dopexamine improves PtissO2 at the serosal side of the gut, preferably at the small bowel. However, low-dose dopexamine did not improve gastric PmucCO2.