Acute hemodynamic effects of dopamine in patients with shock

The hemodynamic effects of dopamine were studied in 62 patients with clinical shock. In 36 patients with infection dopamine increased mean arterial pressure (MAP) 30%, and cardiac output (CO) 37%. Urine flow (UF) increased from 0.5 ml/min to 1.6 ml/min. Norepinephrine (NE) in 26 patients resulted in...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1971-08, Vol.44 (2), p.163-173
Main Authors: Loeb, H S, Winslow, E B, Rahimtoola, S H, Rosen, K M, Gunnar, R M
Format: Article
Language:English
Subjects:
Adult
Aged
Blood Pressure - drug effects
Cardiac Output - drug effects
Cardiac Volume - drug effects
Computers
Dopamine - therapeutic use
Female
Heart Rate - drug effects
Hemodynamics - drug effects
Humans
Indicator Dilution Techniques
Isoproterenol - therapeutic use
Male
Middle Aged
Monitoring, Physiologic
Norepinephrine - therapeutic use
Shock, Cardiogenic - drug therapy
Shock, Septic - drug therapy
Vascular Resistance - drug effects
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Summary:The hemodynamic effects of dopamine were studied in 62 patients with clinical shock. In 36 patients with infection dopamine increased mean arterial pressure (MAP) 30%, and cardiac output (CO) 37%. Urine flow (UF) increased from 0.5 ml/min to 1.6 ml/min. Norepinephrine (NE) in 26 patients resulted in a higher MAP, lower CO, and similar UF. Isoproterenol (Isp) in 19 patients resulted in a lower MAP, higher CO, and a significantly lower UF. In 13 patients with cardiogenic shock dopamine increased MAP 6%, and CO 40%. UF increased from 0.6 ml/min to 1.1 ml/min. NE in eight patients resulted in a lower CO than during dopamine infusion, and Isp in five patients resulted in a higher CO. Dopamine improves MAP pressure, CO, and UF when shock is due to infection and is superior to Isp which does not increase perfusion pressure to adequate levels and does not improve UF. In patients with cardiogenic shock who have reduced CO and increased systemic vascular resistance, perfusion pressure tended to be adequate, and improved CO occurred with dopamine and Isp but not with NE. Although Isp increased CO more than dopamine, differences in regional perfusion are important in selection of the best inotropic agent and in most patients make dopamine the preferred agent.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.44.2.163