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"Renal dose" dopamine in surgical patients: dogma or science?
P W Perdue1, J R Balser, P A Lipsett
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Objective:
"Renal dose" dopamine is widely used in the perioperative period to provide renal protection. A comprehensive review of the literature was performed to determine whether dopamine does in fact confer protection on the kidneys of surgical patients.
Summary Background Data:
Studies in healthy animals and human volunteers reveal that dopamine causes diuresis and natriuresis, as well as some degree of renal vasodilatation.
Results:
Studies of the perioperative use of dopamine fail to demonstrate any benefit of dopamine in preventing renal failure. Studies in congestive heart failure, critical illness, and sepsis also fail to show any benefit of dopamine other than diuresis. Further, dopamine administration is not completely without risk, because of dopamine's catecholamine and neuroendocrine functions.
Conclusions:
Routine use of prophylactic "renal dose" dopamine in surgical patients is not recommended.