Myles P S, Buckland M R, Schenk N J, Cannon G B, Langley M, Davis B B, Weeks A M
Dept of Anaesthesia, Alfred Hospital, Prahran, Victoria, Australia.
Anaesth Intensive Care. 1993 Feb;21(1):56-61. doi: 10.1177/0310057X9302100114.
The efficacy of renal-dose dopamine to improve renal function or reduce renal impairment was studied in 52 patients undergoing elective coronary artery bypass surgery. The patients were prospectively randomised in a double-blind fashion to receive dopamine at 200 micrograms/min (group D) or placebo (group P) from induction for 24 hours. Although dopamine improved haemodynamics, there was no effect on urine output at 4 hours (D = 917, P = 1231 ml: P = 0.066); urine output at 24 hours (D = 3659, P = 3304 ml: P = 0.36); creatinine clearance at 0-4 hours (D = 104, P = 127 ml/min: P = 0.27); creatinine clearance on admission to ICU-4 hours (D = 94.8, P = 83.4 ml/min: P = 0.48); creatinine clearance at 20-24 hours (D = 91.2, P = 107 ml/min: P = 0.48); free-water clearance at 0-4 hours (D = 29.6, P = -59.8 ml/hr: P = 0.069); free-water clearance at 20-24 hours (D = 43.2, P = -48.9 ml/hr: P = 0.55). The incidence of transient renal impairment was similar in both groups (D = 36%, P = 50%: P = 0.65). Our study failed to demonstrate that routine prophylactic renal-dose dopamine is associated with improvement in renal function, or with prevention of transient renal impairment in patients undergoing coronary artery bypass surgery.
在52例接受择期冠状动脉搭桥手术的患者中，研究了肾剂量多巴胺改善肾功能或减轻肾功能损害的疗效。患者被前瞻性地随机分为两组，采用双盲方式，从诱导期开始24小时内，一组接受200微克/分钟的多巴胺（D组），另一组接受安慰剂（P组）。尽管多巴胺改善了血流动力学，但在4小时时对尿量没有影响（D组为917毫升，P组为1231毫升：P = 0.066）；24小时时的尿量（D组为3659毫升，P组为3304毫升：P = 0.36）；0至4小时的肌酐清除率（D组为104毫升/分钟，P组为127毫升/分钟：P = 0.27）；入住重症监护病房4小时时的肌酐清除率（D组为94.8毫升/分钟，P组为83.4毫升/分钟：P = 0.48）；20至24小时的肌酐清除率（D组为91.2毫升/分钟，P组为107毫升/分钟：P = 0.48）；0至4小时的自由水清除率（D组为29.6毫升/小时，P组为 -59.8毫升/小时：P = 0.069）；20至24小时的自由水清除率（D组为43.2毫升/小时，P组为 -48.9毫升/小时：P = 0.55）。两组短暂性肾功能损害的发生率相似（D组为36%，P组为50%：P = 0.65）。我们的研究未能证明常规预防性使用肾剂量多巴胺与冠状动脉搭桥手术患者的肾功能改善或短暂性肾功能损害的预防有关。
