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Intensive Care Medicine

, Volume 24, Issue 11, pp 1217–1220 | Cite as

Dopamine clearance in critically ill patients

  • R. N. Juste
  • L. Moran
  • J. Hooper
  • N. Soni
BRIEF REPORT

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.

Key words Dopamine Steady-state clearance Renal 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • R. N. Juste
    • 1
  • L. Moran
    • 2
  • J. Hooper
    • 2
  • N. Soni
    • 1
  1. 1.Magill Department of Anaesthesia, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK Tel. + 44 (181) 746 8026 Fax + 44 (181) 746 8801GB
  2. 2.Department of Clinical Biochemistry, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UKGB

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