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Dopamine clearance in critically ill patients

R N Juste1, L Moran, J Hooper

  • 1Magill Department of Anaesthesia, Chelsea and Westminster Hospital, London, UK.

Intensive Care Medicine
|January 7, 1999
PubMed
Summary
This summary is machine-generated.

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Low-dose dopamine clearance is significantly lower in critically ill patients, with high variability. This makes it impossible to predict plasma levels from infusion rates, invalidating the "renal" dopamine regimen in this population.

Area of Science:

  • Critical care medicine
  • Pharmacokinetics
  • Renal medicine

Background:

  • The low-dose
  • renal
  • dopamine regimen is commonly used in critically ill patients.
  • However, its effectiveness relies on predictable pharmacokinetics, which may be altered in critical illness.

Purpose of the Study:

  • To assess the validity of the low-dose
  • renal
  • dopamine regimen in critically ill patients.
  • To investigate the steady-state clearance of dopamine in this patient population.

Main Methods:

  • Prospective clinical study conducted in a teaching hospital intensive care unit.
  • 48 hemodynamically stable patients receiving dopamine infusions were included.

Related Experiment Videos

  • Arterial blood and dopamine infusates were sampled for analysis using liquid chromatography with electrochemical detection.

    • Main Results:

    • Dopamine clearance was significantly lower in critically ill patients (46.4 ml/kg/min) compared to elective surgical patients (70 ml/kg/min).
    • Patients with renal dysfunction exhibited even lower dopamine clearances (36 ml/kg/min).
    • A poor correlation was observed between plasma dopamine levels and infusion rates, particularly at low doses (r=0.31).

    Conclusions:

    • Plasma dopamine clearance is reduced and highly variable in critically ill patients.
    • Infusion rates do not reliably predict plasma dopamine levels in this group.
    • The concept of a selective low-dose dopamine infusion for renal effects is invalid in critically ill patients.