Kosugi I, Tajimi K
Circ Shock. 1985;17(2):95-102.
This study was designed to evaluate the effects of dopamine and dobutamine on hemodynamics and plasma catecholamine levels during experimental lactic acid acidosis in dogs. During the normal acid-base state (pH 7.4, PCO2 40 mm Hg), cardiac output and stroke volume were significantly increased and systemic vascular resistance was decreased by the infusion of dopamine or dobutamine 20 mcg/kg/min. Dobutamine produced identical changes in cardiac output, stroke volume, and systemic vascular resistance even during severe lactic acid acidosis (pH 7.0, PCO2 40 mm Hg). Dopamine, however, failed to increase cardiac output and stroke volume and to decrease systemic vascular resistance during lactic acidosis. The plasma norepinephrine level was elevated from 0.49 to 3.01 ng/ml during normal acid-based state and from 1.76 to 9.53 ng/ml during severe lactic acid acidosis by the infusion of dopamine. Dobutamine infusion did not affect the plasma norepinephrine level during normal acid-base state but reduced the level during lactic acid acidosis. The marked increase in plasma norepinephrine following dopamine infusion may explain both the decrease in cardiac output and the increase in systemic vascular resistance in response to dopamine infusion during severe lactic acid acidosis. These results indicate that dobutamine may be more useful than dopamine in improving cardiac output during severe acidosis.
本研究旨在评估多巴胺和多巴酚丁胺对犬实验性乳酸酸中毒期间血流动力学和血浆儿茶酚胺水平的影响。在正常酸碱状态（pH 7.4，PCO2 40 mmHg）下，以20 mcg/kg/min的速度输注多巴胺或多巴酚丁胺可使心输出量和每搏输出量显著增加，全身血管阻力降低。即使在严重乳酸酸中毒（pH 7.0，PCO2 40 mmHg）期间，多巴酚丁胺对心输出量、每搏输出量和全身血管阻力的影响也相同。然而，在乳酸酸中毒期间，多巴胺未能增加心输出量和每搏输出量，也未能降低全身血管阻力。输注多巴胺使正常酸碱状态下血浆去甲肾上腺素水平从0.49 ng/ml升高至3.01 ng/ml，使严重乳酸酸中毒期间从1.76 ng/ml升高至9.53 ng/ml。输注多巴酚丁胺在正常酸碱状态下不影响血浆去甲肾上腺素水平，但在乳酸酸中毒期间可降低该水平。输注多巴胺后血浆去甲肾上腺素的显著升高可能解释了严重乳酸酸中毒期间输注多巴胺后心输出量降低和全身血管阻力增加的原因。这些结果表明，在严重酸中毒期间，多巴酚丁胺在改善心输出量方面可能比多巴胺更有用。
