Gastrointestinal permeability following cardiopulmonary bypass: a randomised study comparing the effects of dopamine and dopexamine

Sinclair, D. G.; Houldsworth, Phillip E.; Keogh, Brian F; Pepper, John; Evans, Timothy W.

doi:10.1007/s001340050366

Cited by 48 publications

(25 citation statements)

References 35 publications

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“…Results are expressed as percentage of enterally administered saccharide recovered in the urine. The ratios of percentage recovery of lactulose to L-rhamnose (L/R) and L-rhamnose to 3OMG (R/3OMG) were calculated to provide specific indices of gut permeability and absorptive capacity respectively [7,18,19,22]. Serum and urinary creatinine levels were also measured in order that the creatinine clearance could be calculated concurrently.…”

Section: Measurement Of Git Mucosal Absorption and Permeabilitymentioning

confidence: 99%

“…It has both inotropic and vasodilator properties, and its administration is associated with an increase in renal, hepatic and splanchnic blood flow [5,6]. In a randomised controlled study, Sinclair et al [7] demonstrated that dopexamine infusion reduces the loss of gut mucosal integrity following cardiopulmonary bypass. Other clinical studies have associated dopexamine administration with improved creatinine clearance following coronary artery bypass surgery and an increased urine output [8].…”

Section: Introductionmentioning

confidence: 99%

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A randomised controlled trial investigating the effects of dopexamine on gastrointestinal function and organ dysfunction in the critically ill

et al. 2002

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Section: Measurement Of Git Mucosal Absorption and Permeabilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial investigating the effects of dopexamine on gastrointestinal function and organ dysfunction in the critically ill

et al. 2002

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“…Our data, in patients following major vascular surgery, is in conflict with a previous study reporting protective effects of dopexamine on gut mucosa following cardiopulmonary bypass. 24 The study suggests that dopexamine infusion (0.5-2 µg·kg -1 ·min -1 ) does not enhance hemodynamic function in patients undergoing elective abdominal aortic aneurysm repair. Throughout most of such surgery, dopexamine did not improve hemodynamic variables and global oxygen delivery compared with the control group.…”

Section: Group I Group Ii Normal Meanmentioning

confidence: 87%

Dopexamine hydrochloride does not modify hemodynamic response or tissue oxygenation or gut permeability during abdominal aortic surgery

McGinley

Lynch

Hubbard

et al. 2001

Can J Anesth/J Can Anesth

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GENERAL ANESTHESIAPurpose: To assess the effects of intraoperative infusion of dopexamine (a DA-1 and B2 adrenoreceptor agonist) on hemodynamic function, tissue oxygen delivery and consumption, splanchnic perfusion and gut permeability following aortic cross-clamp and release.Methods: In a randomised double blind controlled trial 24 patients scheduled for elective infrarenal abdominal aortic aneurysm repair were studied in two centres and were assigned to one of two treatment groups. Group I received a dopexamine infusion starting at 0.5 µg·kg -1 ·min -1 increased to 2 µg·kg -1 ·min -1 maintaining a stable heart rate; Group II received a placebo infusion titrated in the same volumes following induction of anesthesia. Measured and derived hemodynamic data, tissue oxygen delivery and extraction and gut permeability were recorded at set time points throughout the procedure.Results: Dopexamine infusion (0.5 -2 µg·kg -1 ·min -1 ) was associated with enhanced hemodynamic function (MAP 65 ± 5.5 vs 92 ± 5.7 mm Hg, P =<0.05) only during the period of aortic cross clamping. However, during the most part of infrarenal abdominal aortic surgery, dopexamine did not reduce systemic vascular resistance index, mean arterial pressure nor oxygen extraction compared with the control group. The lactulose/ rhamnose permeation ratio was elevated above normal in both groups (0.22 and 0.29 in groups I and II respectively).Conclusions: Dopexamine infusion (0.5 -2 µg·kg -1 ·min -1 ) did not enhance hemodynamic function and tissue oxygenation values during elective infrarenal abdominal aortic aneurysm repair.Objectif : Évaluer les effets d'une perfusion peropératoire de dopexamine, un agoniste des adrénorécepteurs DA-1 et B2, sur l'hémodynamie, l'apport et la consommation d'oxygène tissulaire, la perfusion splanchnique et la perméabilité intestinale à la suite d'un clampage total de l'aorte et de son retrait. Méthode : Il s'agit d'un essai randomisé, contrôlé et à double insu auprès de 24 patients, provenant de deux centres et répartis en deux groupes, qui ont subi la réparation d'un anévrysme aortique abdominal sous-rénal. Le groupe I a reçu une perfusion de dopexamine amorcée à 0,5 µg·kg -1 ·min -1 , augmentée à 2 µg·kg -1 ·min -1 , maintenant une fréquence cardiaque stable; le groupe II a reçu une perfusion placebo de même volume après l'induction de l'anesthésie. Les données hémodynamiques mesurées et dérivées, l'apport et la consommation d'oxygène tissulaire et la perméabilité intestinale ont été notés à des moments de mesure déterminés au cours de l'intervention.Résultats : La perfusion de dopexamine (0,5 -2µg·kg -1 ·min -1 ) a stimulé la fonction hémodynamique (TAM 65 ± 5,5 vs 92 ± 5,7 mm Hg, P = <0,05) pendant le clampage aortique seulement. Cependant, pendant la majeure partie de l'intervention aortique abdominale sous-rénale, la dopexamine n'a pas réduit l'indice de résistance vasculaire générale, la tension artérielle moyenne ou la consommation d'oxygène, ces données étant comparées avec celles du groupe témoin. Le ratio de diss...

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“…Die Inzidenz gastrointestinaler Komplikationen nach EKZ wird mit 0,58-2% angegeben, die Mortalität soll 15-63% betragen [10]. Trotz Stabilisierung der systemischen hämodynami-schen Parameter gibt es aus klinischen Untersuchungen Hinweise auf ein Mißverhältnis zwischen Sauerstoffangebot und -verbrauch im Splanchnikusgebiet und eine gesteigerte Darmpermeabilität nach kardiopulmonalem Bypass [13]. [19].…”

Section: Dopexamine • Splanchnic Perfusion • Cardiac Surgery • Cardiounclassified

“…Klinische Untersuchungen haben gezeigt, daß es durch den Einsatz von Dopexamin zu einer reduzierten Darmpermeabilität [13], bzw. zu einer Verringerung der inflammatorischen Reaktion nach EKZ [3] kommt.…”

Section: Dopexamine • Splanchnic Perfusion • Cardiac Surgery • Cardiounclassified

Splanchnikusperfusion unter Dopexamin bei kardiochirurgischen Eingriffen

et al. 1999

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Gastrointestinal permeability following cardiopulmonary bypass: a randomised study comparing the effects of dopamine and dopexamine

Abstract: Compared to dopamine, dopexamine reduces GIT permeability following surgery involving cardiopulmonary bypass. The mechanism of this effect remains unclear.

Cited by 48 publications

References 35 publications

A randomised controlled trial investigating the effects of dopexamine on gastrointestinal function and organ dysfunction in the critically ill

A randomised controlled trial investigating the effects of dopexamine on gastrointestinal function and organ dysfunction in the critically ill

Dopexamine hydrochloride does not modify hemodynamic response or tissue oxygenation or gut permeability during abdominal aortic surgery

Splanchnikusperfusion unter Dopexamin bei kardiochirurgischen Eingriffen

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