Document Detail


Prolonged infusion of varied doses of dopexamine hydrochloride for low cardiac output after cardiac surgery.
MedLine Citation:
PMID:  1358247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Circulatory failure after cardiac surgery often calls for active hemodynamic management with fluids, inotropes, and vasodilators. Dopexamine hydrochloride is a new combined beta 2-adrenergic and DA1-dopaminergic receptor agonist and an inhibitor of the uptake-1 mechanism of endogenous catecholamines. As a result, it exerts inotropic and vasodilator effects on the heart and systemic vasculature. The effects were examined over a mean of 22 hours, using 1 to 4 micrograms/kg/min of dopexamine to treat low cardiac output states following coronary bypass and valvular/ventricular repair surgery. In 8 out of 14 patients, low cardiac output was readily reversed by 1 microgram/kg/min of dopexamine. Six patients required higher doses (2 to 4 micrograms/kg/min) to achieve a satisfactory cardiac index. Significant changes from control values were observed throughout the infusion for heart rate (67 to 102 beats/min), cardiac index (2.0 to 3.4 L/min/m2), and systemic vascular resistance (1,545 to 914 dyne.s.cm-5). Pulmonary vascular resistance, pulmonary artery wedge pressure, and right atrial pressure were also significantly reduced during the infusion. Most of these changes reversed when dopexamine was discontinued, suggesting a drug-specific effect and a lack of tolerance. Nausea was a frequent complaint, but was no more frequent than in a random sample of similar patients. Titration of dopexamine, 1 to 4 micrograms/kg/min, was efficacious in producing circulatory improvement in patients with a low cardiac output after cardiac surgery.
Authors:
F W Santman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  6     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-12-02     Completed Date:  1992-12-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  568-72     Citation Subset:  IM    
Affiliation:
Department of Intensive Care, University Hospital Nijmegen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic Agonists / administration & dosage,  adverse effects,  therapeutic use*
Adult
Aged
Blood Pressure / drug effects
Cardiac Output / drug effects
Cardiac Output, Low / drug therapy*
Cardiac Surgical Procedures*
Dopamine / administration & dosage,  adverse effects,  analogs & derivatives*,  therapeutic use
Female
Heart Rate / drug effects
Humans
Infusions, Intravenous
Male
Middle Aged
Prospective Studies
Pulmonary Artery / physiology
Pulmonary Wedge Pressure / drug effects
Stroke Volume / drug effects
Time Factors
Vascular Resistance / drug effects
Vasodilator Agents / administration & dosage,  adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Adrenergic Agonists; 0/Vasodilator Agents; 86197-47-9/dopexamine

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


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