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Related Experiment Videos

Increasing splanchnic blood flow in the critically III

N D Maynard1, D J Bihari, R N Dalton

  • 1Department of Surgery, Guy's Hospital, London, United Kingdom.

Chest
|December 1, 1995
PubMed
Summary

Low-dose dopexamine improved splanchnic blood flow in critically ill patients, as indicated by increased gastric intramucosal pH, indocyanine green (ICG) clearance, and lidocaine metabolism. Dopamine showed no significant effect.

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Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Gastroenterology

Background:

  • Splanchnic blood flow is crucial for organ function in critically ill patients.
  • Assessing splanchnic perfusion is challenging but vital for managing systemic inflammatory response syndrome (SIRS).

Purpose of the Study:

  • To evaluate the impact of low-dose dopexamine and dopamine on splanchnic blood flow.
  • To determine if these agents affect gastric intramucosal pH, lidocaine metabolism (MEGX), and indocyanine green (ICG) plasma disappearance rate.

Main Methods:

  • A single-blind, randomized study involving 25 critically ill patients with gastric intramucosal acidosis.
  • Patients received either low-dose dopexamine, dopamine, or saline (control) for 2 hours.
  • Measurements included gastric intramucosal pH, MEGX formation, ICG clearance, and systemic hemodynamic parameters.

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Main Results:

  • Low-dose dopexamine significantly increased gastric intramucosal pH, ICG plasma disappearance rate, and MEGX formation.
  • Dopamine did not alter any measured systemic or splanchnic variables.
  • No significant changes were observed in the saline control group.

Conclusions:

  • Low-dose dopexamine enhances splanchnic blood flow through selective vasodilation.
  • Dopamine, at the tested dose, did not improve splanchnic perfusion.
  • Dopexamine may be a valuable therapeutic option for managing splanchnic ischemia in critically ill patients.