Key result
Fenoldopam administration in dogs during sequential hemorrhage increased gut critical oxygen delivery compared to control (1.12 vs 0.80 ml/kg/min, P<0.05), indicating susceptibility to ischemia.
Why the study?
Does fenoldopam alter systemic and intestinal oxygen delivery-uptake relationships in anesthetized dogs during sequential hemorrhage?
Does fenoldopam alter systemic and intestinal oxygen delivery-uptake relationships in anesthetized dogs during sequential hemorrhage?
Absolute Event Rate: 1.12% vs 0.8%
p-value: p=<0.05
Dopamine-1 receptor stimulation with fenoldopam during critical hypoperfusion increases gut perfusion heterogeneity and susceptibility to ischemia.
May increase gut ischemia risk during hypoperfusion; leaves open D1 agonism effects on human intestinal oxygen delivery.
Effects of a dopamine-1 (DA-1) receptor agonist on systemic and intestinal oxygen delivery (Do(2))-uptake relationships were studied in anesthetized dogs during sequential hemorrhage. Control (group 1) and experimental animals (group 2) were treated similarly except for the addition of fenoldopam (1.0 microg x kg(-1) x min(-1)) in group 2. Both groups had comparable systemic critical Do(2) (Do(2crit)), but animals in group 2 had a higher gut Do(2crit) (1.12 +/- 1.13 vs. 0.80 +/- 0.09 ml. kg(-1) x min(-1), P < 0.05). At the mucosal level, a clear biphasic delivery-uptake relationship was not observed in group 1; thus oxygen consumption by the mucosa may be supply dependent under physiological conditions. Group 2 demonstrated higher peak mucosal blood flow and lack of supply dependency at higher mucosal Do(2) levels. Fenoldopam resulted in a more conspicuous biphasic relationship at the mucosa and a rightward shift of overall splanchnic Do(2crit) despite increased splanchnic blood flow. These findings suggest that DA-1 receptor stimulation results in increased gut perfusion heterogeneity and maldistribution of perfusion, resulting in increased susceptibility to ischemia.
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Guzmán et al. (2003) studied critical hypoperfusion during sequential hemorrhage. fenoldopam vs. Control was evaluated on gut critical oxygen delivery (Do(2crit)) (p=<0.05). Fenoldopam administration in dogs during sequential hemorrhage increased gut critical oxygen delivery compared to control (1.12 vs 0.80 ml/kg/min, P<0.05), indicating susceptibility to ischemia.
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