Document Detail

Is dopexamine superior to dopamine in the treatment of multiple trauma patients--a prospective, double-blind, randomised study.
MedLine Citation:
PMID:  19595327     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The goal of this prospective, randomised, double-blind clinical trial study was to assess the effects of dopexamine hydrochloride on organ failure, inflammatory mediators and splanchnic oxygenation in blunt multiple trauma patients at high risk of multiple organ dysfunction syndrome (MODS). METHODS: We performed a prospective randomised controlled trial on 30 consecutive blunt multiple trauma patients with ISS>or=16, age 18-60 years and initial blood pressure >or=120 mmHg initially admitted to our level I trauma centre. Patients were randomised to treatment with dopamine (n=15) or dopexamine (n=15) for 48 h after admission. Outcome in terms of mortality, MODS, splanchnic perfusion, complications, duration of stay was statistically analysed. RESULTS: Dopexamine treatment was associated with impaired organ function and an increased duration of ventilation and ICU stay compared with patients who received dopamine treatment. The acute inflammatory response was increased in the Dopexamine group while a decreased pHi and MEGX formation and increased serum lactate levels were measured. CONCLUSIONS: The indication to use dopexamine hydrochloride appears questionable. In the absence of an antiinflammatory effect, dopexamine demonstrated a disadvantageous ICU course in regards to the organ function and the duration of treatment. In addition, a decreased pHi and MEGX formation suggested a deterioration of splanchnic oxygenation.
Christian Probst; Frank Hildebrand; Martijn van Griensven; Hellmut Baur; Lutz Mahlke; Christian Krettek; Hans-Christoph Pape; Martin Rolf Wolfgang Grotz
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Injury     Volume:  41     ISSN:  1879-0267     ISO Abbreviation:  Injury     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-05     Completed Date:  2010-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  499-505     Citation Subset:  IM    
Copyright Information:
(c) 2009 Elsevier Ltd. All rights reserved.
Department of Trauma Surgery, Hannover Medical School, 30623 Hannover, Germany.
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MeSH Terms
Blood Pressure / drug effects
Dopamine / analogs & derivatives*,  therapeutic use*
Double-Blind Method
Gastric Mucosa / metabolism
Intensive Care
Length of Stay
Lidocaine / analogs & derivatives,  metabolism
Middle Aged
Multiple Organ Failure / drug therapy*,  metabolism,  mortality
Multiple Trauma / complications*,  metabolism,  mortality
Oxygen Consumption / drug effects
Prospective Studies
Respiration, Artificial
Splanchnic Circulation / drug effects
Trauma Severity Indices
Vasodilator Agents / therapeutic use*
Viscera / blood supply*
Wounds, Nonpenetrating / complications,  metabolism,  mortality
Young Adult
Reg. No./Substance:
0/Vasodilator Agents; 137-58-6/Lidocaine; 7728-40-7/monoethylglycinexylidide; 86197-47-9/dopexamine

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