Bach F, Silomon M, Grundmann U, Stürner J, Graeter T, Larsen R
Klinik für Anästhesiologie und Intensivmedizin, Chirurgische Klinik der Universitätskliniken des Saarlandes Homburg/Saar.
Anaesthesist. 1999 Oct;48(10):713-7. doi: 10.1007/s001010050775.
The present study investigates the effects of dopexamine on the splanchnic perfusion and the general circulation in patients undergoing coronary artery bypass grafting.
34 Patients undergoing elective coronary artery bypass grafting were randomized to receive either dopexamine (1 microg/kg/min) or placebo (0,9% NaCl. ) Cardiac output was measured by thermodilution using a pulmonary artery catheter. Splanchnic blood flow was determined by constant infusion technique of indocyanine green dye (ICG) using a hepatic vein catheter.
Under steady state conditions before surgery, dopexamine increased systemic oxygen supply and cardiac output by an increase in heart rate and stroke volume, with no increase in systemic oxygen demand. Before surgery dopexamine increased splanchnic blood flow together with an increase in cardiac output. After cardiopulmonary bypass dopexamine increased splanchnic perfusion without a concomittant rise in cardiac output.
These results provide evidence that dopexamine improves splanchnic blood flow in patients with coronary artery disease before and after pulmonary bypass without impairment of general hemodynamics.
本研究调查了多培沙明对接受冠状动脉旁路移植术患者内脏灌注和体循环的影响。
34例接受择期冠状动脉旁路移植术的患者被随机分为两组,分别接受多培沙明(1微克/千克/分钟)或安慰剂(0.9%氯化钠)。使用肺动脉导管通过热稀释法测量心输出量。使用肝静脉导管通过吲哚菁绿染料(ICG)持续输注技术测定内脏血流量。
在手术前的稳态条件下,多培沙明通过增加心率和每搏输出量增加了全身氧供和心输出量,而全身氧需求没有增加。手术前,多培沙明增加了内脏血流量,同时心输出量也增加。体外循环后,多培沙明增加了内脏灌注,而心输出量没有随之增加。
这些结果证明,多培沙明可改善冠状动脉疾病患者在体外循环前后的内脏血流量,而不损害总体血流动力学。