Why the study?
Does dobutamine infusion alter haemodynamics and renal function in mechanically ventilated patients after major vascular surgery?
Does dobutamine infusion alter haemodynamics and renal function in mechanically ventilated patients after major vascular surgery?
In mechanically ventilated patients after major vascular surgery, dobutamine improves systemic hemodynamics but does not alter renal blood flow or glomerular filtration rate.
Dobutamine may augment cardiac output without affecting renal hemodynamics after vascular surgery; hypothesis-generating and requires confirmation in larger cohorts.
Eight mechanically ventilated patients were studied, before and during a dobutamine infusion the day after major vascular surgery. During infusion of three different doses of dobutamine (2.5, 5, 10 micrograms/kg/min) increases were found in heart rate of 13%, 21% and 47%, systolic blood pressure of 17%, 27% and 35%, and cardiac output of 11%, 22% and 45%, respectively. Right atrial pressure decreased by 20% at the highest dosage. Pulmonary arterial pressure and pulmonary capillary wedge pressure remained unchanged. There were no changes in plasma catecholamine concentrations and plasma renin activity. Fractional potassium excretion decreased by 23%, 33% and 43%, respectively, at the three dosages, while renal blood flow, glomerular filtration rate, urine flow, fractional sodium, chloride, osmolar and free water clearances were unchanged.
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Westman et al. (1987) studied this question.
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