Haemodynamic and renal effects of dopexamine after cardiac surgery in children
Détails
ID Serval
serval:BIB_0A7015A8E49A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Haemodynamic and renal effects of dopexamine after cardiac surgery in children
Périodique
Anaesthesia and Intensive Care
ISSN
0310-057X
Statut éditorial
Publié
Date de publication
08/1996
Peer-reviewed
Oui
Volume
24
Numéro
4
Pages
435-9
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial --- Old month value: Aug
Journal Article
Randomized Controlled Trial --- Old month value: Aug
Résumé
Dopexamine hydrochloride, a synthetic dopamine analog with predominantly beta and delta agonist properties, has been shown to improve cardiac performance and renal function in adults with heart failure. This study was designed to investigate the haemodynamic and renal effects of dopexamine in children after cardiac surgery. Seven children were selected in whom a need for postoperative vasodilation after cardiac surgery was anticipated. Haemodynamics and renal function were determined under baseline conditions and during a continuous infusion of dopexamine at 2 and 6 micrograms.kg-1.min-1 for 90 minutes, the sequence being randomized for the initial dose. Cardiac output was measured by thermodilution and glomerular filtration rate (GFR) and renal plasma flow (RPF) by the clearances of inulin and para-aminohippurate respectively. Dopexamine induced a dose-related increase in cardiac index (CI) expressed as mean (SD) from 3.5 (0.7) to 3.9 (0.76) and 4.5 (0.8) l.min.-1m-2 (both P < 0.05), and in heart rate (HR) from 107 (17) to 122 (17) and 136 (17) beats.min-1 (P < 0.05). Stroke volume index (SVI) and mean systemic pressure were unchanged, but pulmonary wedge pressure decreased from 14 (3) to 11 (4) and 12 (3) mmHg (both P < 0.05). Systemic vascular resistances (SVR) decreased from 24 (7) to 20 (5) mmHg.l-1.min-1.m-2 (P < 0.05), with dopexamine 6 micrograms.kg-1.min-1. Renal blood flow (RBF) increased from 319 (113) to 441 (230) and 410 (138) ml.min-1.m-2 (both P < 0.05), GFR from 115 (32) to 142 (34) and 146 (29) ml.min-1.1.73m-2 (both P < 0.05), urine output and fractional excretion of sodium respectively from 3.12 (2) to 7.16 (8) and 7.21 (6) ml.kg-1 (both P < 0.05) and from 2.24 (1) to 4.25 (3.4) (P < 0.05) and 3.15 (3.1)% (n.s.). The fraction of CI delivered to the kidneys, the fraction of RBF filtered in the kidneys, plasma renin activity and aldosterone levels remained unchanged. In children after cardiac surgery, dopexamine increases CI at the expense of a concomitant increase in heart rate and demonstrates few selective vascular systemic or intrinsic renal actions.
Mots-clé
Adolescent
*Cardiac Surgical Procedures
Child
Dopamine/administration & dosage/*analogs & derivatives/therapeutic use
Female
Glomerular Filtration Rate/drug effects
Humans
Infusions, Intravenous
Kidney/*drug effects
Male
Postoperative Period
Random Allocation
Renal Circulation/drug effects
Vasodilator Agents/administration & dosage/*therapeutic use
Pubmed
Web of science
Création de la notice
15/01/2008 15:28
Dernière modification de la notice
20/08/2019 13:32