Friedel N, Wenzel R, Matheis G, Kuppe H, Bittner H, Filcek S, Hetzer R
German Heart Institute Berlin.
Eur Heart J. 1992 Sep;13(9):1271-6. doi: 10.1093/oxfordjournals.eurheartj.a060348.
We studied the haemodynamic effects of dopexamine hydrochloride, a beta 2-adrenergic agonist with dopaminergic (DA1) activity, in 20 patients with low cardiac output following surgery for coronary artery bypass grafting and/or valve replacement or repair. Following titration of four doses (1, 2, 4 and 6 micrograms.kg-1.min-1), the dose producing the optimal response was infused for up to 48 h (five patients). During the infusion, significant increases in cardiac index and stroke volume were accompanied by significant decreases in systemic vascular resistance. Heart rate increased significantly up to 6 h and thereafter returned to control levels. Mean blood pressure was reduced but did not fall below 60 mmHg. However, in five patients treated for 48 h mean blood pressure had returned to control levels. Unwanted effects (tachycardia and hypotension) were seen chiefly at higher doses, leading us to conclude that infusion rates of 4 micrograms.kg-1.min-1 or less will be useful in the treatment of low cardiac output following cardiac surgery.
我们研究了盐酸多培沙明（一种具有多巴胺能（DA1）活性的β2肾上腺素能激动剂）对20例冠状动脉搭桥术和/或瓣膜置换或修复术后心输出量低的患者的血流动力学影响。在滴定四种剂量（1、2、4和6微克·千克-1·分钟-1）后，将产生最佳反应的剂量持续输注长达48小时（5例患者）。在输注过程中，心脏指数和每搏输出量显著增加，同时全身血管阻力显著降低。心率在6小时内显著增加，此后恢复到对照水平。平均血压降低，但未降至60 mmHg以下。然而，在接受48小时治疗的5例患者中，平均血压已恢复到对照水平。主要在较高剂量时出现不良反应（心动过速和低血压），这使我们得出结论，4微克·千克-1·分钟-1或更低的输注速率将有助于治疗心脏手术后的心输出量低。
