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Effect of dopexamine on hepatic metabolic activity in patients with septic shock.

Abstract
Hepato-splanchnic metabolic activity is seen to be related to regional blood flow and oxygen/substrate availability in patients with sepsis. Catecholamines, which may modulate metabolic activity perse, are common to stabilize hemodynamics. We studied the effect of a dopexamine-induced increase in splanchnic blood flow (Qspl) on regional metabolic rate in 10 patients with septic shock requiring norepinephrine to maintain mean arterial pressure (>60 mmHg). Splanchnic blood flow was determined using the indocyanine-green method with hepatic venous sampling. We determined the hepato-splanchnic lactate, pyruvate, alanine, and glutamine turnover and the lactate/pyruvate and ketone body ratio as well as the endogenous glucose production (EGP) using the stable isotope approach. Qspl increased from 0.86 (0.79-1.15) to 0.96 (0.92-1.33) L/min/m2, not influencing any parameter of metabolic activity. We speculate that this finding is due to altered beta-adrenoreceptor-mediated thermogenic effects due to the interplay of different beta-sympathomimetics at the receptor site.
AuthorsP Kiefer, I Tugtekin, H Wiedeck, J Vogt, U Wachter, H Bracht, G Geldner, M Georgieff, P Radermacher
JournalShock (Augusta, Ga.) (Shock) Vol. 15 Issue 6 Pg. 427-31 (Jun 2001) ISSN: 1073-2322 [Print] United States
PMID11386613 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Ketone Bodies
  • Lactates
  • Pyruvates
  • Vasodilator Agents
  • dopexamine
  • Glutamic Acid
  • Glucose
  • Alanine
  • Oxygen
  • Dopamine
  • Norepinephrine
Topics
  • Adult
  • Aged
  • Alanine (metabolism)
  • Blood Pressure (physiology)
  • Dopamine (analogs & derivatives, pharmacology, therapeutic use)
  • Female
  • Glucose (metabolism)
  • Glutamic Acid (metabolism)
  • Hemodynamics (drug effects, physiology)
  • Humans
  • Ketone Bodies (metabolism)
  • Lactates (metabolism)
  • Liver (blood supply, drug effects, metabolism)
  • Male
  • Middle Aged
  • Norepinephrine (therapeutic use)
  • Oxygen (blood)
  • Oxygen Consumption (drug effects)
  • Pyruvates (metabolism)
  • Regional Blood Flow (drug effects)
  • Shock, Septic (drug therapy, metabolism, physiopathology)
  • Splanchnic Circulation (drug effects)
  • Vasodilator Agents (pharmacology, therapeutic use)

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