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Haemodynamic effects of dopexamine on postprandial splanchnic hyperaemia
S Bartsch1, A Brüning, F M Reimann
1University Clinics of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
European Journal of Clinical Investigation
|April 17, 2004
Summary
Dopexamine increases blood flow in the gut and portal vein in healthy subjects. This drug does not alter the natural increase in blood flow after a meal, suggesting different mechanisms than enteral nutrition.
Area of Science:
- Physiology
- Pharmacology
- Gastroenterology
Background:
- Dopexamine, a synthetic beta(2)-adrenergic and dopaminergic agonist, is used to prevent splanchnic hypoperfusion in critically ill patients.
- Its interaction with postprandial splanchnic hyperemia and precise mechanism of action remain largely unknown, even in healthy individuals.
Purpose of the Study:
- To investigate the haemodynamic effects of dopexamine on splanchnic and systemic circulation in healthy volunteers.
- To determine if dopexamine affects postprandial splanchnic hyperaemia.
Main Methods:
- A randomized, double-blind, crossover study involving twelve healthy volunteers.
- Assessment of splanchnic (superior mesenteric artery, portal vein, hepatic artery) and systemic haemodynamics using Doppler ultrasound and noninvasive cardiac monitoring.
- Measurements were taken in fasted state and at intervals up to 60 minutes after a liquid meal, with and without dopexamine infusion.
Main Results:
- Dopexamine dose-dependently increased blood flow velocity (TAMX) in the superior mesenteric artery, portal vein, and femoral artery in fasted subjects.
- These increases were proportional to the rise in cardiac index.
- Postprandial increases in superior mesenteric artery and portal vein blood flow velocity were similar in extent to those observed with dopexamine, indicating no significant alteration of physiological hyperaemia.
Conclusions:
- Continuous dopexamine infusion enhances mesenteric and portal perfusion in a dose-dependent manner in healthy humans.
- Dopexamine does not affect the magnitude of physiological postprandial hyperaemia.
- Dopexamine and enteral nutrition may influence splanchnic haemodynamics through distinct pathways.