Document Detail


Dopamine depresses minute ventilation in patients with heart failure.
MedLine Citation:
PMID:  9679718     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Low-dose dopamine is frequently used in patients in the intensive care setting. Dopamine may inhibit chemoreceptor afferents and hence decrease chemoreflex sensitivity to hypoxia. METHODS AND RESULTS: In a double-blind, randomized, crossover study, we determined the effects of dopamine (5 microg x kg(-1) x min(-1)) and placebo infusion on oxygen saturation, minute ventilation, and sympathetic nerve activity during normoxia and 5 minutes of hypoxia in 10 normal young subjects. We further investigated the effects of dopamine and placebo on minute ventilation during normoxic breathing in 8 patients with severe heart failure and in 8 age-matched control subjects. Dopamine did not decrease minute ventilation during normoxia in normal subjects. During hypoxia, minute ventilation was 12.9+/-1.3 L/min on dopamine and 15.8+/-1.5 L/min on placebo (P<0.0001). Oxygen saturation during hypoxia was lower with dopamine (78+/-3%) than placebo (84+/-2%; P<0.0001). Sympathetic nerve activity during hypoxia was not enhanced with dopamine despite the lower O2 saturation. Subjects were able to maintain a voluntary apnea to a lower oxygen saturation on dopamine than on placebo (P<0.05). In heart failure patients breathing room air, but not in age-matched control subjects, dopamine decreased minute ventilation despite decreased oxygen saturation and increased PETCO2 during dopamine (all P< or =0.02). CONCLUSIONS: Dopamine inhibits chemoreflex responses during hypoxic breathing in normal humans, preferentially affecting the ventilatory response more than the sympathetic response. Dopamine also depresses ventilation in normoxic heart failure patients breathing room air. Ventilatory inhibition by low-dose dopamine may adversely influence outcome in hypoxic patients, especially in patients with heart failure.
Authors:
P van de Borne; R Oren; V K Somers
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  98     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-08-13     Completed Date:  1998-08-13     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  126-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine and the Cardiovascular Center, University of Iowa Hospitals and Clinics, Iowa City, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anoxia / drug therapy,  physiopathology
Cardiac Output, Low / drug therapy*,  physiopathology*
Cross-Over Studies
Dopamine / administration & dosage,  therapeutic use*
Dose-Response Relationship, Drug
Double-Blind Method
Female
Humans
Male
Reference Values
Respiration / drug effects*
Grant Support
ID/Acronym/Agency:
1F05 TW05181-01/TW/FIC NIH HHS; HL-14388/HL/NHLBI NIH HHS; HL-24962/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Circulation. 1998 Jul 14;98(2):97-9   [PMID:  9679713 ]

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


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