Inotropes for the management of acute heart failure patients with renal dysfunction. Still an option?

Rafouli‐Stergiou, Pinelopi; Parissis, John; Anastasiou-Nana, Maria

doi:10.1517/14656566.2012.749859

Cited by 15 publications

(10 citation statements)

References 78 publications

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“…If proven correct, it would add to the ongoing discussion on the benefits and perils of the use of dopamine in critical care settings (Rafouli‐Stergiou et al . ).…”

Section: Introductionmentioning

confidence: 97%

“…; Rafouli‐Stergiou et al . ), although the clinical benefits of its administration have increasingly been questioned (Friedrich et al . ; Chen et al .…”

Section: Introductionmentioning

confidence: 99%

“…Dopamine is an endogenous catecholamine that is often used in clinical practice (Giamouzis et al 2010;Rafouli-Stergiou et al 2012), although the clinical benefits of its administration have increasingly been questioned (Friedrich et al 2005;Chen et al 2013). Dopamine at low dose exerts its action by stimulating dopamine receptors dispersed widely within the human body (Hussain & Lokhandwala, 2003).…”

Section: Introductionmentioning

confidence: 99%

“…Such an analysis might be facilitated by the use of the recently developed methodology for studying peripheral chemoreceptor sensitivity (Niewinski et al 2013a). If proven correct, it would add to the ongoing discussion on the benefits and perils of the use of dopamine in critical care settings (Rafouli-Stergiou et al 2012).…”

Section: Introductionmentioning

confidence: 99%

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Consequences of peripheral chemoreflex inhibition with low‐dose dopamine in humans

Niewiński¹,

Tubek²,

Banasiak³

et al. 2014

The Journal of Physiology

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Key pointsr Low-dose dopamine reduces the ventilatory response to acute hypoxia both in animal and in human studies.r In this study we show that low-dose dopamine also attenuates the haemodynamic responses (tachycardia, hypertension) to acute hypoxia in healthy humans.r Moreover, we found that dopamine withdrawal results in a temporary increase in minute ventilation.r The magnitude of the increase in minute ventilation after dopamine withdrawal correlates with the degree of ventilatory response to acute hypoxia and depends on the duration of dopamine administration.r Dopamine may provide a novel method for assessing differences in the level of peripheral chemoreceptor activity, which has important clinical implications given the recently reported pathological role of the carotid body in cardiovascular diseases in animals and humans.Abstract Low-dose dopamine inhibits peripheral chemoreceptors and attenuates the hypoxic ventilatory response (HVR) in humans. However, it is unknown: (1) whether it also modulates the haemodynamic reactions to acute hypoxia, (2) whether it also modulates cardiac baroreflex sensitivity (BRS) and (3) if there is any effect of dopamine withdrawal. We performed a double-blind, placebo-controlled study on 11 healthy male volunteers. At sea level over 2 days every subject was administered low-dose dopamine (2 μg kg -1 min -1 ) or saline infusion, during which we assessed both ventilatory and haemodynamic responses to acute hypoxia. Separately, we evaluated effects of initiation and withdrawal of each infusion and BRS. The initiation of dopamine infusion did not affect minute ventilation (MV) or mean blood pressure (MAP), but increased both heart rate (HR) and cardiac output. Concomitantly, it decreased systemic vascular resistance. Dopamine blunted the ventilatory, MAP and HR reactions (hypertension, tachycardia) to acute hypoxia. Dopamine attenuated cardiac BRS to falling blood pressure. Dopamine withdrawal evoked an increase in MV. The magnitude of the increment in MV due to dopamine withdrawal correlated with the size of the HVR and depended on the duration of dopamine administration. The ventilatory reaction to dopamine withdrawal constitutes a novel index of peripheral chemoreceptor function. (Received 15 October 2013; accepted after revision 2 January 2014; first published online 6 January 2014) Corresponding author P. Niewinski: Department of Cardiology, Centre for Heart Diseases, 4 th Military Hospital, Ul. Weigla 5, 50-981, Wroclaw, Poland. Email: pnsky@wp.pl Abbreviations BR, breathing rate; BRS, baroreflex sensitivity; CB, carotid body; CO, cardiac output; CSN, carotid sinus nerve; GC1, type I glomus cell; HF, high frequency band; HR, heart rate; HRV, heart rate variability; HVR, hypoxic ventilatory response; IQR, interquartile range; LF, low frequency band; MAP, mean arterial pressure; MV, minute ventilation; RR interval, R wave to R wave interval; SEM, standard error of the mean; SBP, systolic blood pressure; S pO 2 , blood oxygen saturation; SVR, systemic vascular resistance;...

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“…If proven correct, it would add to the ongoing discussion on the benefits and perils of the use of dopamine in critical care settings (Rafouli‐Stergiou et al . ).…”

Section: Introductionmentioning

confidence: 97%

“…; Rafouli‐Stergiou et al . ), although the clinical benefits of its administration have increasingly been questioned (Friedrich et al . ; Chen et al .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Consequences of peripheral chemoreflex inhibition with low‐dose dopamine in humans

Niewiński¹,

Tubek²,

Banasiak³

et al. 2014

The Journal of Physiology

View full text Add to dashboard Cite

show abstract

“…Some studies have reported variations in plasma antimicrobial levels in dialysed patients and the need to up-dose to ensure effectiveness, but little information is available on the drugs used to treat HF. 333 Digoxin is not dialyzable, therefore dosage must be adjusted to a glomerular filtration rate of less than 10 ml/min. Amiodarone, however, needs no dosage adjustment during dialysis.…”

Section: Heart Failure and Renal Replacement Therapymentioning

confidence: 99%

Clinical Practice Guideline (CPG). Recommendations on strategy for reducing risk of heart failure patients requiring noncardiac surgery

Escudero¹,

Vecino²,

Baluja³

et al. 2015

Revista Española de Anestesiología y Reanimación (English Editi

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Inotropes in acute heart failure

Bistola

Chioncel

2017

Continuing Cardiol Educ

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Acute heart failure (AHF) encompasses a wide range of clinical presentations, from acute hypertensive heart failure (HF) to low cardiac output hypoperfusion syndromes with cardiogenic shock at the extreme end of this side. Inotropes are pharmacologic agents that enhance cardiac contractility, thereby augmenting cardiac output. Currently, there are three classes of inotropes available in clinical practice with distinct mechanisms of action: beta-adrenergic agonists, phosphodiesterase III inhibitors, and the calcium-sensitizer levosimendan. Inotropes are indicated as short-term therapy in low cardiac output AHF and cardiogenic shock (usually with coadministration of a vasoconstrictor) to increase cardiac output, restore peripheral perfusion, and prevent end-organ dysfunction. Inotropes can cause serious cardiovascular adverse effects, most commonly tachyarrhythmias and myocardial ischemia and are associated with increased medium-and long-term mortality in HF. Therefore, intense monitoring is necessary during their administration, while long-term infusion is contraindicated with the exception of advanced HF patients in whom inotropes may be used as a bridge to a definitive therapy (transplantation or ventricular assist device implantation) or as palliative treatment. Emerging inotropes acting through novel pathways independent of those targeted by conventional agents may overcome safety limitations of currently available agents.Answer questions and earn CME: https://wileyhealthlearning.com/Activity2/ 5608943/Activity.aspx

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Inotropes for the management of acute heart failure patients with renal dysfunction. Still an option?

Cited by 15 publications

References 78 publications

Consequences of peripheral chemoreflex inhibition with low‐dose dopamine in humans

Consequences of peripheral chemoreflex inhibition with low‐dose dopamine in humans

Clinical Practice Guideline (CPG). Recommendations on strategy for reducing risk of heart failure patients requiring noncardiac surgery

Inotropes in acute heart failure

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