Fenoldopam Improves Renal Hemodynamics Impaired by Positive End-Expiratory Pressure

A comparison between fenoldopam and low-dose dopamine in early renal dysfunction of critically ill patients*

“…This behavior is observed in normotensive subjects in whom 0.1 g/kg/min fenoldopam increases renal blood flow more than glomerular filtration rate, with no change in urine volume (14). Similarly, in critically ill patients under mechanical ventilation with positive endexpiratory pressure, the administration of 0.1 g/kg/min fenoldopam decreased renal vascular resistance but did not change urine flow rate, which increased only by higher doses (40). At T1 (i.e., after Ͻ1 day of infusion), urine output with dopamine was significantly higher than with fenoldopam.…”

Mechanical Ventilation and Lung–Kidney Interactions

“…Several small trials have shown that fluid administration and the use of vasoactive drugs (dopamine at 5 g/kg per min or fenoldopam) may improve renal function (24,26,27), but results are not consistently positive (for example, no benefit of dopamine at 2 g/kg per min) (28). It is unlikely that approaches focused solely on the hemodynamic and neurohormonal mechanisms of ALI-induced AKI will be clinically effective in preventing or treating this multifactorial problem, and the development of optimal interventional strategies will require more research into the molecular and cellular mechanisms involved (29).…”

Acute Kidney Injury and Critical Cardiac Disease

“…87 Several reports suggest that fenoldopam infusions provide renal protection after CPB and during critical illness in adults. [88][89][90][91][92][93][94] The data available beyond case reports in the pediatric postoperative cardiac population are limited. In a retrospective cohort study by Costello et al, 95 the addition of fenoldopam to conventional diuretic therapy resulted in improved urine output, decreased inotrope score, and increased blood pressure in children refractory to standard diuretic treatment after cardiac surgery.…”