[Comparison of effect of norepinephrine-dobutamine and that of dopamine alone on splanchnic perfusion in sheep with septic shock].

OBJECTIVE

To compare the effect of norepinephrine-dobutamine and that of dopamine alone on splanchnic perfusion in sheep with septic shock.

METHODS

Twenty sheep with septic shock induced by lipopolysaccharides were divided into two groups. When systolic pressure was decreased to 39.75 mm Hg(1 mm Hg=0.133 kPa), basic values of hemodynamic parameters and intestinal intramucosal pH (pHi) were monitored. The animals were randomized to either receive an intravenous infusion of norepinephrine-dobutamine in combination or dopamine alone, and the dosage was titrated to obtain a mean arterial pressure (MAP)> 90.00 mm Hg with an optimal cardiac preload. Hemodynamic parameters and mucosal pHi were repeatedly measured at 1-, 2-, 3-, 4-hour after basic measurement.

RESULTS

After norepinephrine-dobutamine or dopamine infusion, MAP, cardiac output, and oxygen delivery were increased in all animals compared to basic values in both groups (P<0.05). Compared to baseline values (4.0+/-1.8)mmol/L, lactate concentrations were decreased at 3-hour (2.3+/-1.1) mmol/L and 4-hour (2.1+/-1.1)mmol/L in the norepinephrine-dobutamine group (P<0.05). There were no differences in arterial lactate concentrations in the dopamine group, but arterial pH was decreased from 7.40+/-0.05 to 7.26+/-0.06 at 2-hour (P<0.05 ). No Change in pHi was found in the dopamine group, but in the norepinephrine-dobutamine group, compared to baseline, pHi was increased from 7.19+/-0.04 to 7.36+/-0.07 at 3-hour (P<0.05).

CONCLUSION

Both norepinephrine-dobutamine and dopamine could improve systemic hemodynamics in sheep with septic shock, but the effect of norepinephrine-dobutamine in combination was better than dopamine on splanchnic perfusion.