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Combined dose ratios of dopamine and dobutamine and right ventricular performance after cardiac surgery.

Abstract：

:The effect of combined administration of different dose ratios of dobutamine (DB) and dopamine (DA) (DB/DA ratio of 1:1; 1.5:0.5; 2:0; 0.5:1.5; and 0:2), with the added dose kept constant (10 micrograms/kg/min-20 micrograms/kg/min), on right ventricular function (measured by the thermal washout method with the aid of a rapid-response thermistor) was determined in ten patients after cardiac surgery (between 12 and 24 h after surgery). The following values represent the mean +/- SD of DB only and of the DB/DA-equal combination vs DA only. The DB/DA-equal or DB-dominant combination increased the right ventricular ejection fraction vs DA only (0.39 +/- 0.12 [p less than 0.01] and 0.37 +/- 0.11 [p less than 0.05], respectively, vs 0.32 +/- 0.12) and the stroke volume index (43 +/- 12 ml/m2 [p less than 0.01] and 41 +/- 15 ml/m2, respectively, vs 38 +/- 14 ml/m2) and decreased right ventricular end-diastolic pressure (RVEDP) (10 +/- 4 mm Hg [p less than 0.01] and 11 +/- 4 mm Hg [p less than 0.05], respectively, vs 13 +/- 5 mm Hg) and pulmonary capillary wedge pressure (10 +/- 4 mm Hg [p less than 0.01] and 12 +/- 5 mm Hg [p less than 0.05], respectively, vs 14 +/- 6 mm Hg) to the same degree as DB alone. The DB/DA-equal or DB-dominant combination did not induce tachycardia (heart rate, 105 +/- 11 [p less than 0.05] and 95 +/- 14 beats per minute, respectively, vs 90 +/- 17 beats per minute) or have any effect on the right ventricular end-diastolic volume index (RVEDVI) (115 +/- 30 ml/m2 and 117 +/- 33 ml/m2, respectively, vs 127 +/- 42 ml/m2). Moreover, the diastolic parameters of the right ventricle (the ratio of RVEDVI/RVEDP: 15 +/- 8 [p less than 0.05] and 13 +/- 7, ml/mm Hg/m2, respectively, 11 +/- 5 ml/mm Hg/m2) decreased as the ratio of DA increased. This change in the diastolic properties of the right ventricle might have been caused by release of norepinephrine in the myocardium by DA or by improved coronary perfusion with DB. The DB/DA-equal and DB-dominant combinations were superior to DB or DA alone and to the DA-dominant combination in obtaining enhanced right ventricular performance.

journal_name

Chest

journal_title

Chest

authors

Imai T,Saitoh K,Kani H,Fujita T,Murata K

doi

10.1378/chest.101.5.1197

subject

Has Abstract

pub_date

1992-05-01 00:00:00

pages

1197-202

issue

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)34114-9

journal_volume

101

pub_type

杂志文章

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Combined dose ratios of dopamine and dobutamine and right ventricular performance after cardiac surgery.