Document Detail


Haemodynamic effects of dopexamine on postprandial splanchnic hyperaemia.
MedLine Citation:
PMID:  15086358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The synthetic beta(2)-adrenergic and dopaminergic agonist dopexamine is supposed to prevent splanchnic hypoperfusion in critically ill patients, thus potentially interacting with haemodynamic effects of early enteral nutrition. However, precise mechanism of action and interaction with postprandial splanchnic hyperaemia of the drug are largely unknown, even in healthy subjects. MATERIALS AND METHODS: Twelve healthy volunteers received dopexamine 1 microg x kg(-1) min(-1) and dopexamine and placebo (NaCl 0.9%) 3 microg x kg(-1) min(-1) in a randomized, double-blinded order (crossover-design). Splanchnic (Doppler ultrasound) and systemic (noninvasive cardiac monitoring) haemodynamic parameters were assessed at baseline and during infusion (fasted as well as 15, 30, 45 and 60 min after a standard liquid meal). RESULTS: In fasted humans, dopexamine enhanced time-averaged maximum velocity (TAMX) in the superior mesenteric artery (1 microg + 40%; 3 microg + 82%, P < 0.05), portal vein (+ 63%; + 121%, P < 0.05) and femoral artery (+ 66%; + 87%, P < 0.05), in proportion to the increase of cardiac index (+ 33%; + 77%, both P < 0.05). In the postprandial state, TAMX rose significantly in the superior mesenteric artery (+ 139%) and portal vein (+ 68%) in the placebo group, showing the same absolute extent as dopexamine. The physiological postprandial buffer response of hepatic artery was conserved under all conditions. CONCLUSIONS: Continuous infusion of dopexamine enhances mesenterial and portal perfusion in a dose-dependent manner without affecting the extent of physiological postprandial hyperaemia. Thus, dopexamine and enteral nutrition may interact with splanchnic haemodynamics by different pathways.
Authors:
S Bartsch; A Brüning; F M Reimann; D Ludwig
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of clinical investigation     Volume:  34     ISSN:  0014-2972     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-16     Completed Date:  2004-07-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  England    
Other Details:
Languages:  eng     Pagination:  268-74     Citation Subset:  IM    
Affiliation:
University Clinics of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / ultrasonography
Adrenergic beta-Agonists / therapeutic use*
Adult
Blood Flow Velocity / drug effects
Blood Pressure / drug effects
Dopamine / analogs & derivatives*,  therapeutic use*
Dopamine Agonists / therapeutic use*
Double-Blind Method
Female
Femoral Artery / physiopathology
Hemodynamics / drug effects*
Hepatic Artery / physiopathology
Humans
Hyperemia / prevention & control*,  ultrasonography
Male
Mesenteric Arteries / physiopathology
Middle Aged
Portal Vein / physiopathology
Postprandial Period
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Dopamine Agonists; 86197-47-9/dopexamine

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