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Low-dose dopexamine's effect on lung and gut function after CPB in a sheep model
A Stamler1, H Wang, R M Weintraub
1Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
The Journal of Surgical Research
|May 20, 1998
Summary
Dopexamine did not improve gut mucosal blood flow or reduce lung injury after cardiopulmonary bypass (CPB) in sheep. This study found that CPB still caused gut mucosal ischemia and increased permeability, even with dopexamine treatment.
Area of Science:
- Cardiovascular Surgery
- Gastroenterology
- Pulmonology
Background:
- Cardiopulmonary bypass (CPB) can lead to lung injury, potentially due to gut mucosal dysfunction from ischemia.
- Nonpulsatile CPB may exacerbate gut mucosal ischemia.
Purpose of the Study:
- To investigate if dopexamine, a weak-beta 2 agonist, improves gut mucosal blood flow during CPB.
- To determine if dopexamine reduces gut and lung dysfunction following CPB in an ovine model.
Main Methods:
- Sheep underwent 2 hours of hypothermic, nonpulsatile CPB followed by 2 hours of reperfusion.
- Dopexamine or saline was administered during CPB in a blinded manner.
- Measurements included hemodynamic parameters, thromboxane levels, mesenteric and mucosal blood flow, FD-4 clearance, and tonometric pHi.
Main Results:
- Dopexamine increased heart rate and pulmonary vascular resistance post-CPB.
- Both groups showed decreased mucosal blood flow (Qmuc) and pHi after CPB.
- FD-4 clearance increased post-CPB in both groups, indicating increased permeability, with no significant difference between dopexamine and placebo.
Conclusions:
- Hypothermic CPB induces gut mucosal ischemia and increased permeability in sheep.
- Dopexamine administration did not ameliorate these intestinal issues or reduce post-CPB lung pathophysiology.
- The findings suggest dopexamine is not effective in preventing CPB-associated gut and lung dysfunction.