[Hemodynamic effects of dobutamine in critical patients: discrepancies between parameters of tissue oxygenation and lactic acid].

A retrospective study on the effects of dobutamine on hemodynamic parameters of tissue oxygenation and lactic acid levels was performed in 35 patients. The use of the drug in a mean dose of 5.0 +/- 2.1 ug/kg/min was associated with a significant increase in cardiac index, oxygen transport and consumption and decrease in arterial lactic acid levels. A separate analysis of patients with or without basal hyperlactacidemia and those with favorable (decrease) or unfavorable (no change or increase) lactic acid response to the drug, was performed. This analysis disclosed important disagreements between changes in hemodynamic parameters of oxygen consumption and transport and arterial lactic acid levels, as indexes of tissue perfusion. It is concluded that is advisable to monitor together hemodynamics, oxygen transport and consumption and arterial lactic acid in patients with severe cardiorespiratory disturbances or shock.