Key result
Dopamine increased stroke volume by 16% and heart rate by 31% to achieve a 50% increase in cardiac output, whereas dobutamine increased stroke volume by 9% and heart rate by 38%.
Why the study?
Does dopamine compared to dobutamine differentially affect haemodynamic parameters and urine output in patients in the early postoperative phase after open-heart surgery?
Does dopamine compared to dobutamine differentially affect haemodynamic parameters and urine output in patients in the early postoperative phase after open-heart surgery?
In post-open-heart surgery patients, dopamine and dobutamine achieve similar increases in cardiac output via different haemodynamic mechanisms, with dopamine increasing blood pressure and left atrial pressure, and dobutamine decreasing systemic vascular resistance.
Small crossover study shows comparable haemodynamic effects; leaves open optimal inotrope selection after cardiac surgery.
The haemodynamic effects of dopamine and dobutamine were compared in a cross-over study of 12 patients in the early postoperative phase after open-heart surgery. The drug infusion rates (dopamine (microgram/kg/min) mean 6.5, range 2.8-12, dobutamine (microgram/kg/min) mean 7.9, range 4.3-12.3) were adjusted so that the cardiac output increased by 50%. With both drugs this was achieved through simultaneous increases in stroke volume (dopamine + 16%, dobutamine + 9%) and heart rate (dopamine + 31%, dobutamine + 38%). The systemic vascular resistance did not change with dopamine but decreased significantly (-18%) with dobutamine. Therefore, the systolic and diastolic arterial blood pressures rose significantly more with dopamine than with dobutamine. The left atrial pressure increased with dopamine but was unchanged with dobutamine. The urine output was significantly higher with dopamine than with dobutamine.
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Tydén et al. (1983) studied Early postoperative phase after open-heart surgery (n=12). Dopamine vs. Dobutamine (mean 7.9, range 4.3-12.3 microgram/kg/min) was evaluated on Haemodynamic effects (stroke volume, heart rate, systemic vascular resistance). Dopamine increased stroke volume by 16% and heart rate by 31% to achieve a 50% increase in cardiac output, whereas dobutamine increased stroke volume by 9% and heart rate by 38%.
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