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    
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 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.
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    
Department of Intensive Care, University Hospital Nijmegen, The Netherlands.
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MeSH Terms
Adrenergic Agonists / administration & dosage,  adverse effects,  therapeutic use*
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
Heart Rate / drug effects
Infusions, Intravenous
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*
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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