Meier-Hellmann A, Bredle D L, Specht M, Spies C, Hannemann L, Reinhart K
Department of Anesthesia and Critical Care Medicine, Friedrich Schiller University, Jena, Germany.
Intensive Care Med. 1997 Jan;23(1):31-7. doi: 10.1007/s001340050287.
To assess the effects of low-dose dopamine on splanchnic blood flow and splanchnic oxygen uptake in patients with septic shock.
Prospective, controlled trial.
University hospital intensive care unit.
11 patients with septic shock, diagnosed according the criteria of the 1992 American College of Chest Physicians/Society of Critical Care Medicine consensus conference, who required treatment with norepinephrine.
Systemic and splanchnic hemodynamics and oxygen transport were measured before and during addition of low-dose dopamine (3 micrograms/kg per min). Low-dose dopamine and a marked effect on total body hemodynamics and oxygen transport. The fractional splanchnic flow at baseline ranged from 0.15 to 0.57. In 7 patients with a fractional splanchnic flow less than 0.30, low-dose dopamine increased splanchnic flow and splanchnic oxygen delivery and oxygen consumption. In 4 patients with a fractional splanchnic flow above 0.30, low-dose dopamine did not appear to change splanchnic blood flow.
Low-dose dopamine has a potential beneficial effect on splanchnic blood flow and oxygen consumption in patients with septic shock, provided the fractional splanchnic flow is not already high before treatment.
评估小剂量多巴胺对感染性休克患者内脏血流及内脏氧摄取的影响。
前瞻性对照试验。
大学医院重症监护病房。
11例感染性休克患者，根据1992年美国胸科医师学会/危重病医学会共识会议标准确诊，均需去甲肾上腺素治疗。
在加用小剂量多巴胺（3微克/千克每分钟）之前及期间测量全身和内脏血流动力学及氧输送情况。小剂量多巴胺对全身血流动力学及氧输送有显著影响。基线时内脏血流分数范围为0.15至0.57。7例内脏血流分数小于0.30的患者，小剂量多巴胺增加了内脏血流、内脏氧输送及氧消耗。4例内脏血流分数高于0.30的患者，小剂量多巴胺似乎未改变内脏血流。
对于感染性休克患者，若治疗前内脏血流分数不高，小剂量多巴胺对内脏血流及氧消耗有潜在有益作用。
