Effects of low‐dose dopamine on ventilation in patients with chronic obstructive pulmonary disease

Ciarka, Agnieszka; Rimacchi, R; Vincent, Jean‐Louis; Velez‐Roa, Sonia; Dumonceaux, M.; Leeman, Marc; Borne, P van de

doi:10.1111/j.1365-2362.2004.01375.x

Cited by 5 publications

(2 citation statements)

References 36 publications

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“…Although the authors demonstrated these favorable effects of dopamine on diaphragmatic function, weaning outcome was not reported. Later, Ciarka A. et al investigated the impact of low-dose dopamine on weaning from mechanical ventilation in COPD patients [82]. Dopamine did not attenuate ventilation and had no effect on arterial blood gases.…”

Section: Treatment Strategies In Weaning Failure Of Cardiovascular Ormentioning

confidence: 99%

Weaning failure of cardiovascular origin: how to suspect, detect and treat—a review of the literature

Routsi¹,

Stanopoulos²,

Kokkoris³

et al. 2019

Ann. Intensive Care

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Among the multiple causes of weaning failure from mechanical ventilation, cardiovascular dysfunction is increasingly recognized as a quite frequent cause that can be treated successfully. In this review, we summarize the contemporary evidence of the most important clinical and diagnostic aspects of weaning failure of cardiovascular origin with special focus on treatment. Pathophysiological mechanisms are complex and mainly include increase in right and left ventricular preload and afterload and potentially induce myocardial ischemia. Patients at risk include those with preexisting cardiopulmonary disease either known or suspected. Clinically, cardiovascular etiology as a predominant cause or a contributor to weaning failure, though critical for early diagnosis and intervention, may be difficult to be recognized and distinguished from noncardiac causes suggesting the need of high suspicion. A cardiovascular diagnostic workup including bedside echocardiography, lung ultrasound, electrocardiogram and biomarkers of cardiovascular dysfunction or other adjunct techniques and, in selected cases, right heart catheterization and/or coronary angiography, should be obtained to confirm the diagnosis. Official clinical practice guidelines that address treatment of a confirmed weaning-induced cardiovascular dysfunction do not exist. As the etiologies of weaning-induced cardiovascular dysfunction are diverse, principles of management depend on the individual pathophysiological mechanisms, including preload optimization by fluid removal, guided by B-type natriuretic peptide measurement, nitrates administration in excessive afterload and/or myocardial ischemia, contractility improvement in severe systolic dysfunction as well as other rational treatment in specific indications in order to lead to successful weaning from mechanical ventilation.

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Section: Treatment Strategies In Weaning Failure Of Cardiovascular Ormentioning

confidence: 99%

Weaning failure of cardiovascular origin: how to suspect, detect and treat—a review of the literature

Routsi¹,

Stanopoulos²,

Kokkoris³

et al. 2019

Ann. Intensive Care

View full text Add to dashboard Cite

show abstract

“…mechanisms which can affect ventilation in heart failure: first, direct impairment of gas exchange [73], and second, impaired compensatory ventilation [17]. Both mechanisms can be counterbalanced by the administration of supplemental oxygen [74] We recently investigated the possible impact of DA on weaning from mechanical ventilation in patients with COPD [78]: we observed that DA did not attenuate ventilation and had no effect on arterial blood gases [78]. This discrepancy between patients with COPD and those with heart failure may be explained by differences in the peripheral chemoreceptor drive for ventilation, which is reduced [79,80] in COPD patients and heightened in patients with heart failure [81].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

The effects of dopamine on the respiratory system: Friend or foe?

Ciarka

Vincent²,

Borne

2007

Pulmonary Pharmacology & Therapeutics

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Dopamine (DA) is an immediate precursor of noradrenaline that has stimulatory or inhibitory effects on a variety of adrenergic receptors. DA is primarily used in the management of circulatory shock for its combined vasopressor and inotropic effects, but it may also exert significant effects on the respiratory system Although the respiratory effects of intravenous DA attract less attention than its hemodynamic effects, there is evidence that DA affects ventilation, pulmonary circulation, bronchial diameter, neuromodulation of sensory pulmonary nerves and lung water clearance. Through these complex mechanisms, DA may exert beneficial as well as detrimental effects on respiration. DA may have beneficial effects on the respiratory system by decreasing oedema formation and improving respiratory muscle function, but can also have deleterious effects, by inhibiting ventilation. Hence, DA may be beneficial in lung oedema, but harmful in cases of difficult weaning from mechanical ventilation. DA should be used with caution in patients with heart failure during weaning from mechanical respiration; however, critically ill patients with chronic obstructive pulmonary disease (COPD) do not show this negative effect of DA on ventilatory drive.

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Where Is Dopamine and how do Immune Cells See it?: Dopamine-Mediated Immune Cell Function in Health and Disease

Matt

Gaskill

2019

J Neuroimmune Pharmacol

188

171

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Effects of low‐dose dopamine on ventilation in patients with chronic obstructive pulmonary disease

Abstract: Although low-dose dopamine has been shown to depress ventilation in a variety of conditions, it does not compromise ventilation in COPD patients either breathing spontaneously or when weaned using pressure support ventilation.

Cited by 5 publications

References 36 publications

Weaning failure of cardiovascular origin: how to suspect, detect and treat—a review of the literature

Weaning failure of cardiovascular origin: how to suspect, detect and treat—a review of the literature

The effects of dopamine on the respiratory system: Friend or foe?

Where Is Dopamine and how do Immune Cells See it?: Dopamine-Mediated Immune Cell Function in Health and Disease

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