CORRECTION OF SPLANCHNIC OXYGEN DEFICIT IN THE INTENSIVE-CARE UNIT - DOPEXAMINE AND COLLOID VERSUS PLACEBO

被引:18
作者
TRINDER, TJ
LAVERY, GG
FEE, JPH
LOWRY, KG
机构
关键词
INTENSIVE CARE; DOPEXAMINE; PH; INTRAMUCOSAL; MULTIPLE SYSTEM ORGAN FAILURE; SPLANCHNIC ISCHEMIA; SHOCK;
D O I
10.1177/0310057X9502300209
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Correction of the splanchnic oxygen deficit indicated by low gastric intramucosal pH(pH(i) < 7.35) appears to reduce ICU mortality. Dopexamine hydrochloride is in clinical use for this purpose but its efficacy has not been fully investigated. We report the results of a prospective, randomized, placebo-controlled study with a crossover design to assess the efficacy of dopexamine in correcting low pH(i), Twelve patients in whom pH(i) < 7.32 was detected during eight-hourly monitoring were randomized to receive either incremental dopexamine (4-6 mu g/kg/min) with colloid or 5% dextrose for three hours prior to crossover. There was no difference in pH(i) between treatments despite cardiovascular effects during dopexamine infusion. There was, however, a time-related increase in pH(i) suggesting a beneficial effect of conventional therapy. Dopexamine hydrochloride at 4-6 mu g/kg/min in conjunction with colloid is not a clinically useful therapy to correct the splanchnic oxygen deficit indicated by low pH(i).
引用
收藏
页码:178 / 182
页数:5
相关论文
共 18 条
[1]  
DAHN MS, 1987, SURGERY, V101, P69
[2]   GASTRIC-MUCOSAL PH AS A PROGNOSTIC INDEX OF MORTALITY IN CRITICALLY ILL PATIENTS [J].
DOGLIO, GR ;
PUSAJO, JF ;
EGURROLA, MA ;
BONFIGLI, GC ;
PARRA, C ;
VETERE, L ;
HERNANDEZ, MS ;
FERNANDEZ, S ;
PALIZAS, F ;
GUTIERREZ, G .
CRITICAL CARE MEDICINE, 1991, 19 (08) :1037-1040
[3]  
Fiddian-Green RG, 1992, CLIN INTENS CARE S, V3, P5
[4]  
FINK MP, 1989, SPLANCHNIC ISCHEMIA, P377
[5]   ADEQUACY OF TISSUE OXYGENATION IN INTACT DOG INTESTINE [J].
GRUM, CM ;
FIDDIANGREEN, RG ;
PITTENGER, GL ;
GRANT, BJB ;
ROTHMAN, ED ;
DANTZKER, DR .
JOURNAL OF APPLIED PHYSIOLOGY, 1984, 56 (04) :1065-1067
[6]  
GUTIERREZ G, 1992, LANCET, V339, P196
[7]   2-PERIOD CROSSOVER CLINICAL-TRIAL [J].
HILLS, M ;
ARMITAGE, P .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 1979, 8 (01) :7-20
[8]   APACHE-II - A SEVERITY OF DISEASE CLASSIFICATION-SYSTEM [J].
KNAUS, WA ;
DRAPER, EA ;
WAGNER, DP ;
ZIMMERMAN, JE .
CRITICAL CARE MEDICINE, 1985, 13 (10) :818-829
[10]   CARDIOVASCULAR PHARMACOLOGY OF DOPEXAMINE IN LOW OUTPUT CONGESTIVE HEART-FAILURE [J].
LEIER, CV ;
BINKLEY, PF ;
CARPENTER, J ;
RANDOLPH, PH ;
UNVERFERTH, DV .
AMERICAN JOURNAL OF CARDIOLOGY, 1988, 62 (01) :94-99