Schenarts Paul J, Sagraves Scott G, Bard Michael R, Toschlog Eric A, Goettler Claudia E, Newell Mark A, Rotondo Michael F
The Center of Excellence in Trauma and Surgical Critical Care, University Health Systems of Eastern Carolina, Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina 27858-4354, USA.
Curr Surg. 2006 May-Jun;63(3):219-25. doi: 10.1016/j.cursur.2005.08.008.
In an attempt to prevent or alter the course of acute renal failure, many surgeons continue to use low-dose dopamine. This article critically reviews the physiologic reasons why low-dose dopamine is not clinically efficacious.
A critical review of English language literature.
The effect of dopamine on renal blood flow remains controversial. If dopamine does increase renal blood flow, the vascular anatomy of the kidney would limit its effectiveness. Rather than improving renal function, dopamine has been shown to impair renal oxygen kinetics, inhibit feedback systems that protect the kidney from ischemia, and may worsen tubular injury. Dopamine has not been proven useful in the prevention or alteration of the course of acute renal failure as a result of heart failure, cardiac surgery, abdominal aortic surgery, sepsis, and transplantation. Dopamine has been associated with multiple complications involving the cardiovascular, pulmonary, gastrointestinal, endocrine, and immune systems.
Based on the anatomy and physiology of the kidney, low-dose dopamine would not be expected to improve renal failure and this has been demonstrated by the lack of efficacy in clinical trials.
为了预防或改变急性肾衰竭的病程，许多外科医生继续使用小剂量多巴胺。本文批判性地回顾了小剂量多巴胺在临床上无效的生理原因。
对英文文献进行批判性回顾。
多巴胺对肾血流量的影响仍存在争议。如果多巴胺确实能增加肾血流量，肾脏的血管解剖结构会限制其效果。多巴胺非但不能改善肾功能，反而已被证明会损害肾脏氧动力学，抑制保护肾脏免受缺血损伤的反馈系统，并且可能会加重肾小管损伤。多巴胺尚未被证实可用于预防或改变因心力衰竭、心脏手术、腹主动脉手术、脓毒症和移植导致的急性肾衰竭病程。多巴胺与涉及心血管、肺、胃肠、内分泌和免疫系统的多种并发症相关。
基于肾脏的解剖结构和生理功能，小剂量多巴胺预计不会改善肾衰竭，而这已在临床试验中缺乏疗效得到证实。
