Abstract | BACKGROUND: METHODS: Twenty-eight mature, female, anesthetized sheep (weight, 30.5 +/- 3.6 kg) underwent cecal ligation and perforation and were randomized into four groups of seven animals to be treated with norepinephrine, dopamine- norepinephrine, dobutamine- norepinephrine, or no adrenergic agent. In all groups, lactated Ringer's solution was administered to restore cardiac filling pressures to baseline. In the norepinephrine group, norepinephrine (0.5-5 microg. kg(-1). min(-1)) was titrated to maintain mean arterial pressure between 75-85 mmHg. In the dopamine- norepinephrine group, dopamine was given first, and norepinephrine was added only when mean arterial pressure remained below 75 mmHg despite the infusion of 20 microg. kg(-1). min(-1) dopamine. In the dobutamine- norepinephrine group, dobutamine was started at the same time as norepinephrine and titrated up to 20 microg. kg(-1). min(-1) to get a 15% increase in cardiac output. RESULTS: CONCLUSIONS: In this prolonged septic shock model, association of norepinephrine with either dopamine or dobutamine resulted in the longest survival and the least severe pulmonary lesions. The combination of dobutamine with norepinephrine was associated with a better myocardial performance, greater Do(2) and [OV0312]o(2), lower blood lactate concentration and Pco(2) gap, and less anatomic injury.
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Authors | Qinghua Sun, Zizhi Tu, Suzana Lobo, George Dimopoulos, Nathalie Nagy, Peter Rogiers, Daniel De Backer, Jean-Louis Vincent |
Journal | Anesthesiology
(Anesthesiology)
Vol. 98
Issue 4
Pg. 888-96
(Apr 2003)
ISSN: 0003-3022 [Print] United States |
PMID | 12657850
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Adrenergic Agents
- Cardiotonic Agents
- Sympathomimetics
- Lactic Acid
- Dobutamine
- Dopamine
- Norepinephrine
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Topics |
- Adrenergic Agents
(therapeutic use)
- Animals
- Body Temperature
(drug effects)
- Cardiotonic Agents
(therapeutic use)
- Dobutamine
(therapeutic use)
- Dopamine
(therapeutic use)
- Female
- Hemodynamics
(drug effects)
- Lactic Acid
(blood)
- Norepinephrine
(therapeutic use)
- Oxygen Consumption
(drug effects)
- Peritonitis
(complications)
- Regional Blood Flow
(drug effects, physiology)
- Respiratory Mechanics
(drug effects)
- Sheep
- Shock, Septic
(drug therapy, etiology, physiopathology)
- Survival Analysis
- Sympathomimetics
(therapeutic use)
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