Does dobutamine improve short-term hemodynamic response compared to combined dopamine-sodium nitroprusside therapy in patients with acute myocardial infarction complicated by hypotension and severe left ventricular dysfunction?
Dobutamine provides similar short-term hemodynamic benefits to combined dopamine-sodium nitroprusside therapy in patients with AMI complicated by hypotension and severe LV dysfunction, offering the advantage of single-agent administration.
The short-term response of combined dopamine hydrochloride-sodium nitroprusside therapy was compared with administration of dobutamine in eight patients with acute myocardial infarction complicated by hypotension and severe left ventricular dysfunction. All patients were receiving dopamine before the study began. The addition of sodium nitroprusside increased cardiac index (Cl) from 1.94 +/- 0.490 to 2.22 +/- 0.48 L/min/sq m; decreased left ventricular filling pressure (LVFP) from 28.9 +/- 3.5 to 19.9 +/- 3.3 mm Hg and mean systemic arterial pressure (MAP) from 82.1 +/- 5.1 to 71.5 +/- 6.0 mm Hg. During dobutamine infusion, Cl, LVFP, and MAP were 2.33 +/- 0.31 L/min/sq m, 20.8 +/- 4.8 mm Hg, and 74.1 +/- 8.1 mm Hg, respectively. There was no statistical difference between short-term hemodynamic benefits produced by dobutamine or combined dopamine-sodium nitroprusside therapy. Dobutamine, a synthetic cathecholamine, provides a substitute for dopamine-sodium nitroprusside therapy in acute myocardial infarction. Dobutamine has the advantage of being a single agent and is therefore easier to administer.
Edmund C. Keung (Fri,) studied this question.