Dopamine in the Treatment of Hypotension and Shock

ALTHOUGH sympathomimetic amines with vasoconstrictor (alpha-adrenergic) activity are commonly given to elevate the systemic blood pressure in hypotensive states, their use has been questioned on the basis that vasoconstriction may result in reduced blood flow to visceral organs.1 Most clinically useful sympathomimetic amines, however, also possess potentially beneficial beta-adrenergic activity, which results in increased myocardial contractility.2 Attempts to achieve myocardial stimulation without vasoconstriction have centered on the use of sympathomimetic amines with predominant beta-adrenergic activity (isoproterenol,3 or epinephrine4) or on the conjoint use of alpha-adrenergic blocking agents with amines possessing both alpha and beta activity (norepinephrine5 or metaraminol). Although . . .