Document Detail


Local metabolic effects of dopexamine on the intestine during mesenteric hypoperfusion.
MedLine Citation:
PMID:  14770037     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This self-controlled experimental study was designed to test the hypothesis that dopexamine, a synthetic catecholamine that activates dopaminergic (DA-1) and beta2-adrenergic receptors, improves oxygenation in the jejunal mucosa during intestinal hypotension. In six normoventilated barbiturate-anesthetized pigs, controlled reductions in superior mesenteric arterial pressure (PSMA) was obtained by an adjustable clamp around the artery. Dopexamine infusions (0.5 and 1.0 microg.kg(-1).min(-1)) were administered at a freely variable PSMA (i.e., with the perivascular clamp fully open) and at a PSMA of 50 mmHg and 30 mmHg. We continuously measured superior mesenteric venous blood flow (QMES; transit-time ultrasonic flowmetry), jejunal mucosal perfusion (laser Doppler flowmetry), and tissue oxygen tension (PO2TISSUE; microoximetry). Jejunal luminal microdialysate of lactate, pyruvate, and glucose were measured every 5 min. Measurements of mucosal PCO2 (air tonometry), together with blood sampling and end-tidal PCO2 measurements, enabled calculations of pHi and PCO2 gap. Dopexamine reduced mesenteric vascular resistance and increased QMES at a PSMA of 50 mmHg and 30 mmHg. At a PSMA of 30 mmHg, dopexamine increased mesenteric oxygen delivery but did not influence mesenteric oxygen uptake or extraction. In this situation, dopexamine had no beneficial effect on jejunal mucosal blood flow. On the contrary, dopexamine increased mesenteric net lactate production and PCO2 gap, whereas PO2TISSUE and pHi decreased. Jejunal luminal microdialysate data demonstrated an increased lactate concentration and a pattern of decreased glucose concentration and increased luminal lactate-pyruvate ratio. These negative metabolic effects of dopexamine should be taken into account in situations of low perfusion pressures.
Authors:
Rolf Fröjse; Stefan Lehtipalo; Ulf Bergstrand; Björn Biber; Ola Winsö; Göran Johansson; Conny Arnerlöv
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  21     ISSN:  1073-2322     ISO Abbreviation:  Shock     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-02-10     Completed Date:  2004-10-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  United States    
Other Details:
Languages:  eng     Pagination:  241-7     Citation Subset:  IM    
Affiliation:
Department of Surgical and Perioperative Sciences, Umeå University Hospital, Umeå, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / pharmacology
Animals
Blood Pressure
Catecholamines / pharmacology
Dopamine / analogs & derivatives*,  pharmacology*
Female
Intestinal Mucosa / drug effects,  pathology
Intestines / drug effects*
Jejunum / pathology
Laser-Doppler Flowmetry
Mesenteric Arteries / pathology*
Microdialysis
Oxygen / metabolism
Perfusion*
Pressure
Receptors, Adrenergic, beta-2 / metabolism
Swine
Time Factors
Ultrasonics
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Catecholamines; 0/Receptors, Adrenergic, beta-2; 7782-44-7/Oxygen; 86197-47-9/dopexamine

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


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