Are the effects of noradrenaline, adrenaline and dopamine infusions on $$\dot VO_2 $$ and metabolism transient?and metabolism transient?

Abstract

Administration of noradrenaline, adrenaline or dopamine resulted in persistent increases in VO2 in volunteers. With the exception of the transient adrenaline effect on fatty acids the metabolic actions were steady during 4 h of adrenergic stimulation. Since the adrenergic effect on VO2 is persistent over time a similar action in patients (e.g. septic shock) during treatment with adrenoceptor agonists may be important. Thus, an increase in VO2 during therapy may not only reflect an oxygen debt but also a pharmacodynamic action of adrenoceptor mediated calorigenic and metabolic induction.

Comparison of norepinephrine and dobutamine to epinephrine for hemodynamics, lactate metabolism, and gastric tonometric variables in septic shock: a prospective, randomized study

“…In volunteers, epinephrine increases blood glucose, glycerol, lactate, and VO 2 [13,16] through an increase in glycolysis. Recently, in patients with severe sepsis without shock, Day et al [17] reported an increase in lactate level without an increase in calculated VO 2 .…”

“…At low doses, epinephrine acts predominantly on the peripheral Recent studies [11,12] have suggested that b 2 agonists like dobutamine and dopexamine improve splanchnic perfusion in critically ill patients. Moreover, norepinephrine and dobutamine are less thermogenic than epinephrine [13,14] and may have a more desirable effect on the adequacy of splanchnic oxygenation. There is still a lack of clinical studies which compare, in a randomized manner, what combinations of inotropes and/or vasopressors are most suitable in optimizing the systemic and regional hemodynamics in hyperdynamic septic shock patients.…”

Different dosages of dobutamine in septic shock patients: determining oxygen consumption with a metabolic monitor integrated in a ventilator

“…In healthy volunteers administration of catecholamines resulted also in a persistent increase in VO 2 due to elevated myocardial VO 2 and stimulation of b 2 receptors with increased gluconeogenesis and lipolysis [34]. The influence of exogenous catecholamines on VO 2 in septic patients is controversial and may be due to different dosage regimens.…”

Metabolic Effects of Norepinephrine and Dobutamine in Healthy Volunteers

“…However, the impact of the metabolic effects of adrenergic agents in patients is not known. In contrast, the metabolic effects of epinephrine are well investigated in healthy volunteers, even in a dose range that is used in clinical practice (11)(12)(13). Epinephrine increases glucose production, both from glycogenolysis and gluconeogenesis, Cori-cycle-activity, and the release of free fatty acids and fatty acid cycling (14)(15)(16).…”