• Rev Bras Ter Intensiva · Mar 2007

    [Low-doses dobutamine and fluids in high-risk surgical patients: effects on tissue oxygenation, inflammatory response and morbidity].

    • Adriana da Silva Arantes, Antônio Carlos Christiano Júnior, Sônia Portela de Abreu, Janaína Maria Miranda Ferreira de Moraes, Joelma Villafanha Gandolfi, Lauriane Gomes Leite, and Suzana Margareth Lobo.
    • Hospital de Base, FAMERP.
    • Rev Bras Ter Intensiva. 2007 Mar 1; 19 (1): 5-13.

    Background And ObjectivesDobutamine is an inotropic agent with predominant beta1- adrenergic properties frequently used to increase blood flow in critically ill patients. Dobutamine may have a role in increasing splanchnic perfusion, thereby protecting this area from further injury. We investigated the effects of low doses dobutamine (5 mug/kg/min) on tissue oxygenation, inflammatory response and postoperative complications in high-risk surgical patients.MethodsProspective, randomized, blinded and placebo-controlled study. One hundred surgical patients admitted in a step-down unit were evaluated and 82 patients were enrolled, 42 in the control group (saline) and 40 in the treatment group (5 mug/kg/h) during 24 hours. Similar therapeutic goals were applied to both groups. Fluids were given whenever tachycardia or hypotension developed after study drug infusion.ResultsThe total volume of fluids given was significantly higher in treatment than in control group (7351 ± 2082 mL versus 6074 ± 2386 mL, respectively, p < 0.05). Central venous oxygen saturation (ScvO2), serum lactate and C-reactive protein were similar in both groups. Complications occurred in 35% and 50% of the patients in the treatment and control groups, respectively (RR 0, 70 IC 95% 0.41 - 1.17; NS).ConclusionsLow-doses dobutamine and fluids after surgical trauma has no effects on the prevalence of postoperative complications in high-risk surgical patients.

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