DOPAMINE AND DOBUTAMINE DID NOT IMPROVE A LOW GASTRIC INTRAMUCOSAL PH FOLLOWING CARDIOPULMONARY BYPASS

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We investigated whether dopamine or dobutamine could improve low gastric intramucosal pH (pHi) and high lactate levels following cardiopulmonary bypass (CPB). Eighteen patients, after cardiac surgery with CPB, who had low pHi (<7.35) but without a low cardiac index (Cl) (>2.2 l・min^<-1>・m^<-2>) during the baseline infusion of approximately 5 μg・kg^<-1>・min^<-1> of dopamine were enrolled. Additional dopamine and dobutamine were administered sequentially to 10 patients in the catecholamine group. Hemodynamics, oxygen delivery index (Do_2I), oxygen consumption index (Vo_2I), pHi and serum lactate concentrations were measured at baseline, after additional administration of 5μg・kg^<-1>・min^<-1> of dopamine (DA 5 point), 5μg・kg^<-1>・min^<-1> (DB 5 point) and 10 μg・kg^<-1>・min^<-1> (DB 10 point) of dobutamine and on the first postoperative day (1 POD). The other 8 patients served as the control (control group). In the catecholamine group, the pHi and lactate levels at the DA 5, DB 5 or DB 10 points did not change despite the increase in the CI and Do_2I. The pHi (7.39±0.05 vs 7.31±0.03; p<0.01) and lactate levels (16.4±6.7 vs 42.1±14.1 mg・dl^<-1>; p<0.01) improved significantly on 1 POD compared with baseline levels. In the control group, neither the pHi nor lactate levels changed within 3.5 hours. The pHi (7.39±0.04 vs 7.30±0.04; p<0.01) and lactate levels (22.1±10.6 vs 44.6±9.0 mg・dl^<-1>; p<0.01) improved significantly on 1 POD. The increase in the oxygen delivery due to catecholamine infusion did not improve the low pHi and high lactate levels following CPB.
名古屋市立大学の論文
2005-05-31

DOPAMINE AND DOBUTAMINE DID NOT IMPROVE A LOW GASTRIC INTRAMUCOSAL PH FOLLOWING CARDIOPULMONARY BYPASS

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