• A Meier-Hellmann, D L Bredle, M Specht, L Hannemann, and K Reinhart.
• Department of Anesthesiology and Intensive Care Medicine, Friedrich Schiller University, Jena, Germany.
• Crit. Care Med. 1999 Oct 1;27(10):2166-71.

ObjectiveTo assess the effects of dopexamine on splanchnic blood flow and splanchnic oxygen uptake in septic patients.DesignA prospective, controlled trial.SettingA ten-bed intensive care unit (ICU) in a university hospital.PatientsTwelve patients with severe sepsis (according to the criteria of the 1992 American College of Chest Physicians/Society of Critical Care Medicine consensus conference) being stabilized by volume loading and treated to an elevated oxygen delivery by dobutamine infusion.InterventionsInfusion of increasing dosages of dopexamine (0.5, 1.0, 2.0, and 4.0 microg/kg/min).Measurements And Main ResultsSystemic and splanchnic hemodynamic and oxygen transport parameters as well as gastric mucosal pH (pHi) were measured. A hepatic venous catheter technique with indocyanine green dye dilution was used to determine splanchnic blood flow. Dopexamine increased global and splanchnic oxygen delivery without affecting oxygen consumption (VO2). Splanchnic blood flow increased proportionally to cardiac output, indicating that there was no selective effect of dopexamine on the splanchnic flow. Dopexamine decreased pHi in a dose-dependent fashion in all 12 patients.ConclusionsIn hemodynamically stable, hyperdynamic septic patients being treated with dobutamine, dopexamine has no selective effect on splanchnic blood flow. In fact, a decreased pHi suggests a harmful effect on gastric mucosal perfusion.

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