Document Detail


Acute effects of dobutamine and dopamine on renal and respiratory functions in patients on prolonged mechanical ventilation.
MedLine Citation:
PMID:  1823215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
1. It is known that positive pressure mechanical ventilation (PPMV) decreases diuresis and increases extravascular water, thereby impairing pulmonary gas exchange. Sympathomimetic amines are commonly used to relieve these effects. To compare the effects of dobutamine (DT) and dopamine (DP) on renal and pulmonary function, we studied 30 patients submitted to continuous PPMV for at least 72 h. All were in stable hemodynamic conditions. Patients had pulmonary insufficiency of different etiology. The drugs were randomly administered by continuous intravenous infusion at the dose of 4 to 6 micrograms kg-1 min-1 for 3 h. An interval of 60 min was allowed to elapse between treatments. 2. A significant increase in arterial pressure and heart rate occurred with both drugs (P less than 0.05). DP increased urinary flow by 93.7% (1.6 +/- 0.1 to 3.1 +/- 0.4 ml/min; P less than 0.05) and Na excretion fraction (NaEF) by 35.5% (P less than 0.05). In contrast, DT reduced NaEF by 58.9% (P less than 0.05) and had no effect on urinary flow. Neither drug altered creatinine clearance. 3. The alveolo-arterial O2 difference (A-aO2D), which was 370 +/- 20 mmHg during the control period, increased to 394 +/- 20 mmHg after DP and decreased to 355 +/- 22 mmHg after DT, the difference being statistically significant (P less than 0.05). Pulmonary shunt (%) and the venous pO2 (mmHg) did not change during the infusion of DP or DT. 4. In conclusion, an acute increase in salt and water excretion does not necessarily lead to an immediate reduction in pulmonary "shunt".(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J A Ramires; A Tsanaclis; H C Gimenez; P L da-Luz; F Pileggi
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Brazilian journal of medical and biological research = Revista brasileira de pesquisas médicas e biológicas / Sociedade Brasileira de Biofísica ... [et al.]     Volume:  24     ISSN:  0100-879X     ISO Abbreviation:  Braz. J. Med. Biol. Res.     Publication Date:  1991  
Date Detail:
Created Date:  1992-09-22     Completed Date:  1992-09-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8112917     Medline TA:  Braz J Med Biol Res     Country:  BRAZIL    
Other Details:
Languages:  eng     Pagination:  35-42     Citation Subset:  IM    
Affiliation:
Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, Brasil.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Dobutamine / administration & dosage,  pharmacology*
Dopamine / administration & dosage,  pharmacology*
Female
Hemodynamics / drug effects
Humans
Infusions, Intravenous
Kidney / drug effects,  physiology*
Lung / drug effects,  physiology*
Male
Middle Aged
Positive-Pressure Respiration*
Pulmonary Circulation / drug effects
Random Allocation
Renal Circulation / drug effects
Respiratory Insufficiency / physiopathology,  therapy
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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