Abstract
The introduction of drugs that could induce hypotension with different pharmacological actions would be advantageous because side effects unique to a specific drug could be minimized by selecting appropriate therapy. Specific dopamine-1, (DA1) and dopamine-2 (DA2) receptor agonists are now under clinical investigation. Fenoldopam mesylate is a specific DA1 receptor agonist that lowers blood pressure by vasodilatation. The hypothesis that fenoldopam could be used to induce hypotension and preserve blood flow to the kidney was tested. Systemic aortic blood pressure and renal blood flow were measured continuously with a carotid arterial catheter and an electromagnetic flow probe respectively, in order to compare the cardiovascular and renal vascular effects of fenoldopam and sodium nitroprusside in ten dogs under halothane general anaesthesia. Mean arterial pressure was decreased 30 ± 8 per cent from control with infusion of fenoldopam (3.4 ± 2.0 μg · kg− 1 · min− 1) and 34 ± 4 per cent with infusion of sodium nitroprusside (5.9 μg · kg− 1 · min− 1) (NS). Renal blood flow (RBF) increased during fenoldopam-induced hypotension 11 ± 7 per cent and decreased 21 ± 8 per cent during sodium nitroprusside-induced hypotension (P < 0.01). Sodium nitroprusside is a non-selective arteriolar and venous vasodilator that can produce redistribution of blood flow away from the kidney during induced hypotension. Fenoldopam is a selective dopamine-1 (DA1) receptor agonist that causes vasodilatation to the kidney and other organs with DA1 receptors and preserves blood flow to the kidney during induced hypotension.
Abstract
L’introduction d’agents qui induisent l’hypotension par des actions pharmacologiques différentes pourrait être avantageuse afin de minimiser les effets secondaires spécifiques des agents par une thérapie sélective appropriée. Des agonistes spécifiques des récepteurs dopamine-1 (DA1) et dopamine-2 (DA2) sont actuellement investigués. Le fénoldopam mésylate est un agoniste spécifique des récepteurs DA1 qui diminue la pression artérielle par vasodilatation. On a testé l’hypothèse que le fénoldopam pourrait être utilisé pour induire l’hypotension et préserver le flot rénal. Afin de comparer les effets cardiovasculaires et rénaux du fénoldopam et du nitroprussiate de soude chez dix chiens anesthésiés à halothane, on a mesuré la pression artérielle systémique et le flot rénal avec un cathéter carotidien et un débitmètre électromagnétique. La pression artérielle moyenne diminua de 30 ± 8 pour cent du contrôle avec la perfusion de fénoldopam 3,4 ± 2,0 μg · kg− 1) et 34 ± 4 pour cent avec l’infusion de nitroprussiate de soude (5,9 μg · kg− 1 · min− 1) (NS). Le flot sanguin rénal (RBF) augmenta durant l’hypotension induite par le fénoldopam 11 ± 7 pour cent et diminua de 21 ± 8 pour cent durant l’hypotension induite par le nitroprussiate de soude (P < 0,01). Le nitroprussiate de soude est un vasodilatateur non-sélectif artériolaire et veineux qui peut produire une redistribution de flot sanguin loin des reins durant l’hypotension induite. Le fénoldopam est un agoniste des récepteurs DA1 qui provoque une vasodilatation rénale et autres organes ayant des récepteurs DA1 préservant ainsi le flot sanguin rénal durant l’hypotension induite.
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Supported in part by NIH Grant GM22220.
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Aronson, S., Goldberg, L.I., Roth, S. et al. Preservation of renal blood flow during hypotension induced with fenoldopam in dogs. Can J Anaesth 37, 380–384 (1990). https://doi.org/10.1007/BF03005596
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DOI: https://doi.org/10.1007/BF03005596