Multiple extremity amputations in hypotensive patients treated with dopamine.

Dopamine hydrochloride has been established as effective in the treatment of hypotension and shock in patients with adquate blood volume. The physiological response is dose related. Administration of more than 10 microgram/kg/min results in alpha-receptor stimulation and vasoconstriction, and peripheral extremity ischemia has been reported. Four patients treated with dopamine subsequently had the development of peripheral ischemia and gangrene, resulting in the need for multiple extremity amputations. These reactions represent a major complication of treatment.