Comparison of the effects of dobutamine, dopamine, and isoproterenol on hypoxic pulmonary vasoconstriction in the pig

Furman, William R.; Summer, Warren R.; Kennedy, Thomas P.; Sylvester, J. T.

doi:10.1097/00003246-198206000-00007

Cited by 43 publications

(11 citation statements)

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“…The present results are in keeping with previous reports that dobutamine does not affect pulmonary vascular pressure/flow relationships in canine unilateral pulmonary edema (8) or embolic pulmonary hypertension (9). However, they are at variance with the observations of decreased lobar Ppa at constant flow, at baseline, and more so after administration of a vasoconstricting endoperoxide analog, in cats (10) or decreased slope of Ppa/Q plots in isolated pigs lungs with hypoxic vasoconstriction (11). In a previous study from our laboratory, we showed in intact dogs that dobutamine at 10 g·kg Ϫ1 ·min Ϫ1 did not affect (Ppa Ϫ Ppao)/Q plots in hyperoxia and in hypoxia but increased (Ppa Ϫ Ppao) at the lowest Q in hyperoxia and decreased (Ppa Ϫ Ppao) at all levels of Q tested in hypoxia at the higher dose of 20 g·kg Ϫ1 ·min Ϫ1 n (7).…”

Section: Discussionsupporting

confidence: 93%

“…However, whether dobutamine decreases PVR independently of associated changes in flow remains uncertain. In controlled flow conditions, dobutamine has been reported either not to affect (7,8,9), to decrease (10,11), or even to increase (7,10) the gradient between pulmonary artery pressure (Ppa) and occluded pulmonary artery pressure (Ppao) (or left atrial pressure), depending on dose, experimental model, and ambient PO 2 .…”

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confidence: 99%

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Pulmonary vascular effects of dobutamine in experimental pulmonary hypertension

Pagnamenta

Fesler

Vandinivit

et al. 2003

Critical Care Medicine

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Pulmonary vascular effects of dobutamine in experimental pulmonary hypertension

Pagnamenta

Fesler

Vandinivit

et al. 2003

Critical Care Medicine

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“…Also, PA flow significantly increased with no appreciable change in PA pressure. This is consistent with the findings by Furman et al (32) who showed that DB (2-20 g/kg/min) prevented hypoxic pulmonary vasoconstriction and decreased PVR in swine. Studies performed in children have demonstrated conflicting results.…”

Section: Catecholamine Administrationsupporting

confidence: 93%

Right Ventricular Injury in Young Swine: Effects of Catecholamines on Right Ventricular Function and Pulmonary Vascular Mechanics

et al. 2000

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Acute right ventricular (RV) injury is commonly encountered in infants and children after cardiac surgery. Empiric medical therapy for these patients results from a paucity of data on which to base medical management and the absence of animal models that allow rigorous laboratory testing. Specifically, exogenous catecholamines have unclear effects on the injured right ventricle and pulmonary vasculature in the young. Ten anesthetized piglets (9 -12 kg) were instrumented with epicardial transducers, micromanometers, and a pulmonary artery flow probe. RV injury was induced with a cryoablation probe. Dopamine at 10 g/kg/min, dobutamine at 10 g/kg/min, and epinephrine (EP) at 0.1 g/ kg/min were infused in a random order. RV contractility was evaluated using preload recruitable stroke work. Diastolic function was described by the end-diastolic pressure-volume relation, peak negative derivative of the pressure waveform, and peak filling rate. In addition to routine hemodynamic measurements, Fourier transformation of the pressure and flow waveforms allowed calculation of input resistance, characteristic impedance, RV total hydraulic power, and transpulmonary vascular efficiency. Cryoablation led to a stable reproducible injury, decreased preload recruitable stroke work, and impaired diastolic function as measured by all three indices. Infusion of each catecholamine improved preload recruitable stroke work and peak negative derivative of the pressure waveform. Dobutamine and EP both decreased indices of pulmonary vascular impedance, whereas EP was the only inotrope that significantly improved transpulmonary vascular efficiency. Although all three inotropes improved systolic and diastolic RV function, only EP decreased input resistance, decreased pulmonary vascular resistance, and increased transpulmonary vascular efficiency. Abbreviations RV, right ventricle DA, dopamine DB, dobutamine EP, epinephrine PRSW, preload recruitable stroke work EDPVR, end-diastolic pressure-volume relationship Kc, right ventricular chamber stiffness dP/dt min , peak negative value of the RV pressure waveform derivative Qpk, peak filling rate TVE, transpulmonary vascular efficiency PA, pulmonary artery PVR, pulmonary vascular resistance Acute RV injury is encountered in infants and children with congenital heart disease after cardiac surgery (1). Despite its frequent occurrence, the ideal therapeutic strategy to manage the young patient with acute RV systolic and/or diastolic dysfunction remains unknown. The management of infants and children with RV dysfunction in the intensive care unit is centered on providing adequate oxygen delivery through manipulations of the cardiac and respiratory systems. Techniques used to augment cardiac output after RV injury include inotropic support and manipulation of loading conditions (2, 3). Despite widespread use of inotropes, little is known about their detailed interactions on RV systolic function (2), RV diastolic function, and the pulmonary vasculature (4). Although these drugs may enhance intrinsic RV ...

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“…(3) Inotropes directly inhibit HPV [39][40][41][42]. (4) Mixed venous oxygen tension affects the stimulus oxygen tension responsible for initiation of HPV.…”

Section: Shunt Fractionmentioning

confidence: 99%

Arterial oxygenation and one-lung anesthesia

Levin

Coetzee

2008

Current Opinion in Anaesthesiology

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The effects of anesthesia techniques on oxygen consumption, cardiac output and therefore mixed venous oxygenation can significantly affect arterial oxygenation during one-lung anesthesia. While pursuing increases in cardiac output may, under limited circumstances, benefit arterial oxygenation during one-lung ventilation, this approach is not a panacea and does not obviate the necessity to optimize dependent lung volume.

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Comparison of the effects of dobutamine, dopamine, and isoproterenol on hypoxic pulmonary vasoconstriction in the pig

Cited by 43 publications

References 0 publications

Pulmonary vascular effects of dobutamine in experimental pulmonary hypertension

Pulmonary vascular effects of dobutamine in experimental pulmonary hypertension

Right Ventricular Injury in Young Swine: Effects of Catecholamines on Right Ventricular Function and Pulmonary Vascular Mechanics

Arterial oxygenation and one-lung anesthesia

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