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Comparison of norepinephrine-dobutamine to dopamine alone for splanchnic perfusion in sheep with septic shock
Yi Yang1, Hai-Bo Qiu, Shao-Xia Zhou
1Department of Critical Care Medicine, Zhong-Da Hospital and School of Clinical Medicine, Southeast University, Nanjing 210009, China. YiYiYang@hotmail.com
Aim:
To compare the effect of norepinephrine-dobutamine with dopamine alone on splanchnic perfusion in sheep with septic shock.
Methods:
Twenty sheep with septic shock induced by lipopolysaccharides were divided into two groups. When systolic pressure decreased by 5.3 kPa, basic values of hemodynamic parameters and intestinal intramucosal pH (pHi) were recorded. Each group was randomized to receive an intravenous infusion of norepinephrine-dobutamine or dopamine, and titrated to obtain mean arterial pressure (MAP) > 12 kPa with an optimal cardiac preload. Hemodynamic parameters and mucosal pHi were repeated at 1, 2, 3, and 4 h after basic measurement.
Results:
After norepinephrine-dobutamine or dopamine infusion, MAP, cardiac output, and oxygen delivery increased in all animals compared with basic values in both groups (P < 0.05). Compared with baseline values, lactate concentrations decreased at 3 h and 4 h [from (4 +/- 2) mmol/L to (2 +/- 1) mmol/L] in the norepinephrine-dobutamine group (P < 0.05 ). Arterial lactate concentrations had no change in dopamine group, but arterial pH decreased from 7.40 +/- 0.05 to 7.26 +/- 0.06 at 1 h (P < 0.05 ). No difference in pHi was found in dopamine group, but in the norepinephrine-dobutamine group, compared with baseline, pHi increased from 7.19 +/- 0.04 to 7.36 +/- 0.07 at 3 h (P < 0.05).
Conclusion:
Both norepinephrine-dobutamine and dopamine alone could improve systemic hemodynamics in sheep with septic shock, but norepinephrine-dobutamine was better than dopamine on splanchnic perfusion.
