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Dobutamine in elderly septic shock patients refractory to dopamine

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Abstract

The hemodynamic effects of dobutamine (2.5–20 μg/kg per min) were studied in six elderly patients with septic shock which was refractory to dopamine (15 μg/kg per min). Dobutamine infusion resulted in significant increases in cardiac index (CI), stroke index (SI) and left ventricular stroke work index (LVSWI) and similar declines in heart rate (HR), mean pulmonary artery pressure (MPAP), pulmonary capillary wedge pressure (PCWP), systemic vascular resistance (SVR) and total pulmonary resistance (TPR). Dose response curves demonstrated a linear rise in CI with increasing doses of dobutamine and parallel decreases in HR and PCWP. MAP was unchanged. These data indicate that dobutamine may be a useful adjunct to dopamine therapy in the management of elderly patients with septic shock.

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References

  1. Akhtar N, Mikulic E, Cohn JN, Chaudry MF (1975) Hemodynamic effect of dobutamine in patients with severe heart failure. Anesth J Cardiology 36:202

    CAS  Google Scholar 

  2. Carrico CJ, Meakins JL, Marshall JC, Fry D, Maier RV (1986) Multiple organ failure syndrome. Arch Surg 121:196

    Article  CAS  PubMed  Google Scholar 

  3. Eiseman B, Bert R, Norton L (1977) Multiple organ failure. Surg Obstet Gynecol 144:323

    CAS  Google Scholar 

  4. Goldberg LI, Hsieh YY, Resonebor L (1977) Newer catecholamines for treatment of heart failure and shock: an update on dopamine and a first look at dobutamine. Prog Cardiovasc Dis 19:327

    Article  CAS  PubMed  Google Scholar 

  5. Goldberg LI, Talley RC, McNay JL (1969) The potential role of dopamine in the treatment of shock. Prog Cardiovasc Dis 12:240

    Article  Google Scholar 

  6. Hess ML, Hastillo A, Greenfield LJ (1981) Spectrum of cardiovascular function during gram-negative sepsis. Prog Cardiovasc Dis 23:279

    Article  CAS  PubMed  Google Scholar 

  7. Jardin F, Gurdjian F, Desfonds P, Margairaz A (1979) Effects of dopamine on intra-pulmonary shunt fraction and oxygen transport in severe sepsis with circulatory and respiratory failure. Crit Care Med 7:273

    Article  CAS  PubMed  Google Scholar 

  8. Jardin F, Sprotiche M, Bazine M, Bourobka A, Margairaz A (1981) Dobutamine: a hemodynamic evaluation in human septic shock. Crit Care Med 9:329

    Article  CAS  PubMed  Google Scholar 

  9. Leier CV, Unverferth DV, Kates RE (1979) The relationship between plasma dobutamine concentrations and cardiovascular responses in cardiac failure. Am J Med 66:238

    Article  CAS  PubMed  Google Scholar 

  10. Loeb HS, Bredakis J, Gunnar RM (1977) Superiority of dobutamine over dopamine for augmentation of cardiac output in patients with chronic low output cardiac failure. Circulation 55:375

    Article  CAS  PubMed  Google Scholar 

  11. Loeb HS, Khan M, Klodnycky ML, Towne WD, Gunnar RM (1975) Hemodynamic effects of dobutamine in man. Circ Shock 2:29

    Google Scholar 

  12. MacDonald RH, Goldberg LI, McNay JL, Tuttle EP (1964) Effects of dopamine in man: augmentation of sodium excretion, glomerular filtration rate and renal plasma flow. J Clin Invest 43:1116

    Article  Google Scholar 

  13. MacLean LD, Mulligan WG, McLean APH, Duff JG (1967) Patterns of septic shock in man: a detailed study of 56 patients. Ann Surg 166:543

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Majerus TC, Chodoff P, Borel CO (1984) Dopamine and dolutamine in septic shock: a comparison. Arch Intern Physiol Biochem 92:S 65

    Google Scholar 

  15. Regnier B, Rapin M, Gorgy G, Lemaire F, Teisseire B, Harari A (1977) Hemodynamic effects of dopamine in septic shock. Intensive Care Med 3:47

    Article  CAS  PubMed  Google Scholar 

  16. Regnier B, Safran D, Carlet J, Teisseire B (1979) Comparative hemodynamic effects of dopamine and dobutamine in septic shock. Intensive Care Med 5:115

    Article  CAS  PubMed  Google Scholar 

  17. Ruffolo RR Jr, Yaden EL (1983) Effects of the stereoisomers of dobutamine. J Pharmacol Exp Ther 224:46

    CAS  PubMed  Google Scholar 

  18. Siegel JH, Greenspan M, DelGuercio LM (1967) Abnormal vascular tone, defective oxygen transport and myocardial failure in human septic shock. Ann Surg 165:504

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Talley RC, Goldberg LI, Juhnson CE, McNay JL (1969) A hemodynamic comparison of dopamine and isoproterenol in patients in shock. Circulation 34:361

    Article  Google Scholar 

  20. Tuttle RR, Mills J (1975) Dobutamine: development of a new catecholamine to selectively increase cardiac contractility. Circ Res 36:185

    Article  CAS  PubMed  Google Scholar 

  21. Winslow EJ, Loeb HS, Rahimtoola SH, Kamath S, Gunnar RM (1973) Hemodynamic studies and results of therapy in 50 patients with bacteremic shock. Am J Med 54:421

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA

    B. Tell & L. Flancbaum

  2. Department of Clinical Pharmacology, Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland, USA

    T. C. Majerus

Authors
  1. B. Tell
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  2. T. C. Majerus
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  3. L. Flancbaum
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Tell, B., Majerus, T.C. & Flancbaum, L. Dobutamine in elderly septic shock patients refractory to dopamine. Intensive Care Med 13, 14–18 (1987). https://doi.org/10.1007/BF00263550

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  • DOI: https://doi.org/10.1007/BF00263550

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