Key result
Combining low-dose dopamine with dobutamine in patients with acute myocardial infarction and cardiac failure increased urinary flow from 68 to 107 ml/h.
Why the study?
Does the combination of low-dose dopamine and dobutamine improve haemodynamic parameters and urinary flow compared to dobutamine alone in patients with acute myocardial infarction and cardiac failure?
Does the combination of low-dose dopamine and dobutamine improve haemodynamic parameters and urinary flow compared to dobutamine alone in patients with acute myocardial infarction and cardiac failure?
In patients with acute myocardial infarction and cardiac failure, combining low-dose dopamine with dobutamine enhances diuresis without compromising the haemodynamic benefits of dobutamine.
Answers are grounded in this paper and cite their sources.
Optimal dobutamine reduces wedge pressure and resistance in AMI with failure; extends RCT data on inotrope titration in acute HF.
The haemodynamic effects of an optimal dose of dobutamine (DUo) (6.7 +/- 4.2 micrograms kg-1 min-1) and the combination of this optimal dose minus 2.5 micrograms kg-1 min-1 of dobutamine (DU) plus dopamine 2.5 micrograms kg-1 min-1 (DA) were studied in a first group of 12 consecutive patients with acute myocardial infarction (AMI) and cardiac failure (CF). DUo decreased pulmonary wedge pressure from 23.5 to 16 mm Hg (P less than 0.01), systemic vascular resistance from 1 774 to 1 417 dynes s cm-5 (P less than 0.01). DUo increased cardiac output from 3.21 to 4.55 litres/min (P less than 0.01) and urinary flow (UF) from 20 to 68 ml/h (P less than 0.01). Heart rate and blood pressure did not change significantly. DUo - DU + DA significantly increased UF from 68 to 107 ml/h (P less than 0.05) while the other parameters remained unchanged with respect to DUo. The positive effect of DA on UF was confirmed in a second group of 12 consecutive patients by comparing the successive effects of DA + DUo and DUo + DU : all previously described parameters remained unchanged except UF which decreased from 107 to 65 (P less than 0.01). We conclude that in patients with CF and AMI, association of DA and DUo is useful in obtaining both inotropic and diuretic effects.
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Allaf et al. (1984) studied Acute myocardial infarction and cardiac failure (n=24). Dobutamine and dopamine combination vs. Optimal dose of dobutamine (6.7 +/- 4.2 micrograms/kg/min) was evaluated on Urinary flow (p=<0.05). Combining low-dose dopamine with dobutamine in patients with acute myocardial infarction and cardiac failure increased urinary flow from 68 to 107 ml/h.
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