Document Detail


The effects on arterial haemoglobin oxygen saturation and on shunt of increasing cardiac output with dopamine or dobutamine during one-lung ventilation.
MedLine Citation:
PMID:  15535486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Theoretically, if the cardiac output were increased in the presence of a given intrapulmonary shunt, the arterial saturation should improve as the venous oxygen extraction per ml of blood decreases if the total oxygen consumption remains constant. Previous work demonstrated that this was not achieved with adrenaline or isoprenaline as increased shunting negated any benefit from improved cardiac output and mixed venous oxygen content. However pharmacological stimulation of cardiac output and venous oxygen without any increase in shunt should achieve the goal of improved arterial oxygenation. To test this hypothesis, seven pigs were subjected to one-lung ventilation and infused on separate occasions, with dopamine and with dobutamine in random order to increase the cardiac output. The mixed venous oxygen content, shunt fraction, oxygen consumption and arterial oxygen saturation were measured. With both dopamine and dobutamine there was a consistent rise in venous oxygen content. However, with dopamine, the mean shunt rose from 28% to 42% and with dobutamine, the mean shunt rose from 45% to 59% (both changes P<0.01). With dopamine, the mean arterial oxygen saturation fell by 4.7%, and with dobutamine by 2.9%, but neither fall was statistically significant. It is concluded that any benefit to arterial saturation which might occur from a dopamine- or dobutamine-induced increase in mixed venous oxygen content during one-lung ventilation is offset by increased shunting. During one-lung anaesthesia, there would appear to be no benefit to arterial saturation in increasing cardiac output with an infusion of either dopamine or dobutamine.
Authors:
W J Russell; M F James
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  32     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-11-10     Completed Date:  2005-01-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  644-8     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, University of Cape Town, South Africa.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / pharmacology
Analysis of Variance
Animals
Blood Gas Analysis
Cardiac Output / drug effects*
Disease Models, Animal
Dobutamine / pharmacology*
Dopamine / pharmacology*
Female
Hemoglobins / metabolism*
Male
Oxygen / blood
Oxygen Consumption / drug effects*
Probability
Random Allocation
Reference Values
Respiration, Artificial*
Sensitivity and Specificity
Swine
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Hemoglobins; 34368-04-2/Dobutamine; 7782-44-7/Oxygen

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


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