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  • 1
    Electronic Resource
    Electronic Resource
    Dopamine clearance in critically ill patients (1998)
    Springer
    Intensive care medicine 24 (1998), S. 1217-1220 
    Details
    ISSN: 1432-1238
    Keywords: Key words Dopamine ; Steady-state clearance ; Renal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To examine the validity of the low-dose “renal” dopamine regimen in critically ill patients by investigating the steady-state clearance of dopamine. Design: A prospective clinical study. Setting: Teaching hospital intensive care unit. Patients: 48 haemodynamically stable patients receiving a dopamine infusion. Interventions: Sampling of arterial blood and dopamine infusates. Measurement and results: Plasma and infusate dopamine levels were measured by liquid chromatography with electrochemical detection. Steady-state clearance was determined by dividing the actual infusion rate by the steady-state plasma concentration. Dopamine clearance for the whole group was 46.4 ± 35.9 ml/kg per min (mean ± SD), which is significantly lower than 70 ± 15.2 ml/kg per min reported for elective surgical patients (p = 0.01). Twelve patients with renal dysfunction had significantly lower dopamine clearances (36 ± 16.6 ml/kg per min) than the remaining 36 patients (61 ± 38.5 ml/kg per min, p = 0.022). There was a very poor correlation between plasma dopamine level and infusion rate for the group as a whole (r = 0.47), and this worsened (r = 0.31)when only those patients on a “renal” dose of 2–5 μg/kg per min were considered (n = 30). Conclusion: Plasma dopamine clearance is lower in critically ill patients and there is a large interindividual variation. It is therefore impossible to predict the plasma level from the infusion rate. Consequently, the concept of a selective renovascular low-dose dopamine infusion is invalid in critically ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050747
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    The effects of low-dose dopamine infusions on haemodynamic and renal parameters in patients with septic shock requiring treatment with noradrenaline (1998)
    Springer
    Intensive care medicine 24 (1998), S. 564-568 
    Details
    ISSN: 1432-1238
    Keywords: Key words Dopamine ; Haemodynamic ; Renal ; Sepsis ; Shock ; Noradrenaline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To investigate whether low-dose dopamine (LDD) has a significant effect on systemic haemodynamic variables and renal function when used in conjunction with high-dose noradrenaline in optimally volume-resuscitated patients with septic shock. Design: A prospective clinical study in which each patient acted as his/her own control. Setting: Teaching hospital Intensive Care Unit. Patients: Twenty-one patients with septic shock treated with high-dose noradrenaline were studied, 17 patients completed the study. Interventions: Fluid loading to an optimal left ventricular stroke work index (LVSWI) whilst on more noradrenaline than 10 mcg/min and dopamine of 2.5 mcg/kg per min. Three study periods each of 2 h with LDD present, withdrawn and restarted. During each period a complete haemodynamic profile and measurement of urine flow rate, creatinine clearance and sodium excretion was performed. Measurement and results: Removing and restarting LDD caused marked changes in cardiac index (CI, 17 % fall, p 〈 0.01: 23 % rise, p 〈 0.01), stroke volume (SV, 11 % fall, p 〈 0.05: 14 % rise, p 〈 0.05) and systolic blood pressure (SBP, 11 % fall, p 〈 0.05: 14 % rise, p 〈 0.05). Urine volume fell by 40 % (p 〈 0.05) when dopamine was withdrawn. Significant reductions in sodium excretion (p 〈 0.05) and fractional sodium excretion (p 〈 0.05) also occurred on stopping LLD. Changes in creatinine clearance were not statistically significant. Conclusion: Low-dose dopamine causes significant increases in SBP SV, cardiac output and urine flow during treatment with noradrenaline.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050616
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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