Trinder T J, Lavery G G, Fee J P, Lowry K G
Royal Victorian Hospital, Belfast, N. Ireland.
Anaesth Intensive Care. 1995 Apr;23(2):178-82. doi: 10.1177/0310057X9502300209.
Correction of the splanchnic oxygen deficit indicated by low gastric intramucosal pH (pHi < 7.35) appears to reduce ICU mortality. Dopexamine hydrochloride is in clinical use for this purpose but its efficacy has not been fully investigated. We report the results of a prospective, randomized, placebo-controlled study with a crossover design to assess the efficacy of dopexamine in correcting low pHi. Twelve patients in whom pHi < 7.32 was detected during eight-hourly monitoring were randomized to receive either incremental dopexamine (4-6 micrograms/kg/min) with colloid or 5% dextrose for three hours prior to crossover. There was no difference in pHi between treatments despite cardiovascular effects during dopexamine infusion. There was, however, a time-related increase in pHi suggesting a beneficial effect of conventional therapy. Dopexamine hydrochloride at 4-6 micrograms/kg/min in conjunction with colloid is not a clinically useful therapy to correct the splanchnic oxygen deficit indicated by low pHi.
通过低胃黏膜内pH值（pHi < 7.35）所表明的内脏氧亏的纠正似乎可降低重症监护病房（ICU）的死亡率。盐酸多培沙明正用于此目的，但尚未对其疗效进行充分研究。我们报告一项前瞻性、随机、安慰剂对照且采用交叉设计的研究结果，以评估多培沙明纠正低pHi的疗效。在每八小时一次的监测中检测到pHi < 7.32的12例患者被随机分组，在交叉前先接受递增剂量的多培沙明（4 - 6微克/千克/分钟）加胶体溶液或5%葡萄糖溶液治疗三小时。尽管在输注多培沙明期间有心血管效应，但各治疗组之间的pHi并无差异。然而，pHi有随时间的升高，提示传统治疗有有益作用。4 - 6微克/千克/分钟的盐酸多培沙明联合胶体溶液并非纠正由低pHi所表明的内脏氧亏的临床有用疗法。
