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Effects of dopexamine in comparison with fenoterol on carbohydrate, fat and protein metabolism in healthy volunteers

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Abstract

Objective

In critically ill patients adrenergic agonists are used to treat haemodynamic disorders. Their metabolic actions should be considered in controlling metabolic homeostasis. Dopexamine has assumed effects on carbohydrate, fat and protein metabolism. The aim of this study was to define its metabolic actions and compare these with those of fenoterol by using a stable isotope dilution technique.

Design

Prospective, randomized experimental study.

Setting

Experimental section of a university anaesthesiology department.

Participants

Twenty-seven healthy male volunteers in three groups with nine participants each.

Interventions

Participants received a 4-h infusion of dopexamine (2.25 µg/kg per min), fenoterol (at least 0.025 µg/kg per min) or saline.

Measurements and results

Before and every 80 min during drug infusion, we measured endogenous glucose production and the plasma appearance rates for leucine and urea. In addition, we measured plasma concentrations of glucose, lactate, free fatty acids (FFAs), noradrenaline, adrenaline, insulin, glucagon and potassium. Endogenous glucose production did not differ among the groups. Glucose plasma concentration and glucose clearance remained constant during the dopexamine infusion. Fenoterol increased glucose plasma concentration and decreased glucose clearance. Lactate, FFAs, insulin and noradrenaline plasma concentrations were increased and the rate of leucine appearance was decreased by both drugs. The rate of urea appearance did not differ from the control group.

Conclusions

Dopexamine has no or only weak effects on carbohydrate metabolism, its effects on fat and protein metabolism are comparable to those of fenoterol. This metabolic profile may be advantageous in increasing cardiac output in patients with impaired glucose tolerance.

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Authors and Affiliations

  1. University Clinic of Anaesthesiology, University Clinics Ulm, Steinhoevelstrasse 9, 89075 , Ulm, Germany

    Wolfgang Geisser, Josef Vogt, Ulrich Wachter, Hannes Hofbauer, Michael Georgieff & Hermann Ensinger

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  1. Wolfgang Geisser
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  2. Josef Vogt
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  3. Ulrich Wachter
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  4. Hannes Hofbauer
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  5. Michael Georgieff
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  6. Hermann Ensinger
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Corresponding author

Correspondence to Wolfgang Geisser.

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Geisser, W., Vogt, J., Wachter, U. et al. Effects of dopexamine in comparison with fenoterol on carbohydrate, fat and protein metabolism in healthy volunteers. Intensive Care Med 30, 702–708 (2004). https://doi.org/10.1007/s00134-003-2124-1

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  • DOI: https://doi.org/10.1007/s00134-003-2124-1

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