Hemodynamic and Renal Effects of Dopexamine and Dobutamine in Patients With Reduced Cardiac Output Following Coronary Artery Bypass Grafting

Hemodynamic and Renal Effects of Dopexamine and Dobutamine in Patients With Reduced Cardiac Output Following Coronary Artery Bypass GraftingLeft ventricular dysfunction is frequently encountered following invasive cardiac surgical procedures, including coronary artery bypass grafting (CABG). Treatment options for improving cardiac function after CABG include B-adrenergic agonists (epinephrine, dobutamine, and dopamine), phosphodiesterase inhibitors (amrinone and milrinone), vasodilators (nitroprusside and nitroglycerine), and in-tra-aortic balloon counter pulsation 2 Dobutamine is commonly used after CABG, in part due to the beneficial effect of combining positive inotropic support with peripheral vasodilatation and afterload reduction.” The splanchnic and renal vasodilatory effects of low-dose dopamine (0.5 to 3 ^g/kg/min) enhance sodium and water excretion, making this agent attractive for use in patients following open heart procedures Unfortunately, the hemodynamic effects of inotropic doses of dopamine are less favorable for recovering myocardium, as doses above 5 /xg/ kg/min commonly produce coronary and peripheral vasoconstriction and excessive tachycardia.
Dopexamine, a synthetic agent with agonist activity at both B2-adrenergic and dopaminergic receptors, has been shown to be beneficial in augmenting both cardiac output and splanchnic (renal) blood flow in low-output congestive heart failure.” It has also been shown to increase sodium and water excretion via the kidneys.” The combined inotropic, vasodilatory, diuretic, and natriuretic effects could be beneficial for the postcardiac surgical patient, for whom inotropic and diuretic agents are often required. The purpose of the current study was to compare the hemodynamic, diuretic, and natriuretic effects of dopexamine with dobutamine in patients with low cardiac index (Cl) upon separation from extracorporeal circulation. asthma inhalers

This entry was posted in Cardiac Surgery and tagged Cardiac surgery (CABG), dobutamine, dopexamine, inotropic support (inotropy).