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Haemodynamic and renal effects of dopexamine after cardiac surgery in children

W Habre1, M Beghetti, C Roduit

  • 1Intensive Care Unit, University Pediatric Clinic, Hôpital des Enfants, Geneva, Switzerland.

Anaesthesia and Intensive Care
|August 1, 1996
PubMed

Insights

Dopexamine hydrochloride increased cardiac index and renal blood flow in children after cardiac surgery. However, it also raised heart rate without improving stroke volume index or selective renal actions.

Area of Science:

  • Cardiology
  • Pediatric Critical Care
  • Pharmacology

Background:

  • Dopexamine hydrochloride, a synthetic dopamine analog, exhibits beta and delta agonist properties.
  • Previous studies indicated dopexamine improves cardiac and renal function in adult heart failure patients.
  • The efficacy and effects of dopexamine in pediatric post-cardiac surgery patients remain less understood.

Purpose of the Study:

  • To investigate the hemodynamic and renal effects of dopexamine in children following cardiac surgery.
  • To assess the dose-dependent impact of dopexamine on cardiac output, systemic vascular resistance, and renal function.
  • To determine if dopexamine offers selective vascular or intrinsic renal benefits in this pediatric population.

Main Methods:

  • A study involving seven pediatric patients anticipated to require postoperative vasodilation after cardiac surgery.
  • Hemodynamic parameters and renal function markers were measured at baseline and during dopexamine infusion (2 and 6 µg/kg/min).
  • Cardiac output (thermodilution), glomerular filtration rate (inulin clearance), and renal plasma flow (para-aminohippurate clearance) were assessed.

Main Results:

  • Dopexamine administration led to a dose-related increase in cardiac index (CI) and heart rate (HR).
  • Pulmonary wedge pressure and systemic vascular resistance (SVR) decreased, while stroke volume index (SVI) remained unchanged.
  • Renal blood flow (RBF), glomerular filtration rate (GFR), and urine output significantly increased with dopexamine treatment.

Conclusions:

  • Dopexamine effectively increases cardiac index in children post-cardiac surgery, primarily by increasing heart rate.
  • The drug demonstrates vasodilatory effects, reducing systemic vascular resistance and improving renal blood flow and function.
  • Dopexamine shows limited selective vascular actions and no significant intrinsic renal effects beyond improved flow in this patient group.

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