Der Einflu� von Dopamin auf H�modynamik und Nierenfunktion bei der schweren Herzinsuffizienz des Menschen

Ramdohr, B; Schüren, K. P.; Biamino, Giancarlo; Schröder, Rolf

doi:10.1007/bf01482468

Cited by 35 publications

(5 citation statements)

References 28 publications

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“…In 50% of normal men heart rates increase in the dose range of 10-15 µg/kg/min and frequent ventricular extrasystoles are seen above this dose (Horwitz et al 1962). The consensus seems that it is often dangerous and even useless to administer more than 25µg/kg/min (Goldberg 1972;Ramdohr et al 1973). From these facts we decided to administer dopamine at 20µg/kg/min in the present study.…”

Section: Discussionmentioning

confidence: 97%

Effect of dopamine on regional pulmonary perfusion.

Isawa¹,

Teshima²,

Hirano³

et al. 1981

Tohoku J. Exp. Med.

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Dopamine effect on regional pulmonary perfusion in the right upper lobe was studied in 6 dogs in which the lobe was isolated by a balloon catheter and artificially ventilated with nitrogen, air or 60% oxygen in nitrogen, while the rest of the lungs was allowed spontaneous air respiration. Dopamine was administered at the rate of 20µg/kg/min. Each dog served as its own control. There was no change in the regional vascular responses to the different alveolar oxygen tensions in the right upper lobe before and after dopamine administration, alveolar hyperoxia; alveolar hypoxia; dopamine; hyperoxic pulmonary vascular recruitment and/or vasodilation; hypoxic pulmonary vasoconstriction

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Section: Discussionmentioning

confidence: 97%

Effect of dopamine on regional pulmonary perfusion.

Isawa¹,

Teshima²,

Hirano³

et al. 1981

Tohoku J. Exp. Med.

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“…We believe that it is justified to extrapolate our haemodynamic results to many clinical situations following open heart surgery during which inotropic support is necessary. Some authors (Ramdohr et al, 1973;Loeb, Bredakis and Junner, 1977;Schroeder, 1977) recommend that the dose of dopamine should be limited to 5 y.g kg" 1 min" 1 because greater infusion rates may be associated with increases of the left ventricular filling pressure which may offset the benefit of inotropic support. On the other hand, several studies (Harrison, Kerber and Aldermann, 1970;Sunder-Plassmann et al, 1974;Goldberg, 1977;Leier et al, 1978) demonstrate that greater doses of dopamine are often necessary to increase cardiac output in patients with severe heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…The property of dopamine to exert inotropic effects and to increase the left ventricular filling pressure concomitantly without affecting systemic vascular resistance is specific and not shared by other catecholamines. The increase of pre-load is supposed to be a result of two mechanisms: (1) dopamine induces a blood volume shift from the peripheral to the central circulation by venous constriction (Ramdohr et al, 1973);…”

Section: Discussionmentioning

confidence: 99%

“…Dopamine is favoured at present for the treatment of low cardiac output states (Bergerovich et al, 1974) because of its unique ability to dilate splanchnic and renal vessels, coupled with inotropic and moderate chronotropic effects. In contrast to other clinically used catecholamines, an increase of left ventricular filling pressure during treatment with dopamine was observed by several authors (Ramdohr et al, 1973;Loeb, Bredakis and Junner, 1977;Schroeder, 1977;Leier et al, 1978). Loeb and others reported that dopamine treatment may be associated with pulmonary oedema.…”

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confidence: 93%

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Haemodynamic Effects of Dopamine and Dopamine Combined With Nitroglycerin in Patients Subjected to Coronary Bypass Surgery

Heß

Klein

Mueller-Busch

et al. 1979

British Journal of Anaesthesia

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The haemodynamic effects of dopamine and dopamine with nitroglycerin were evaluated in eight patients with coronary heart disease who underwent aortocoronary bypass surgery. The study was performed under anaesthesia and before surgery. Dopamine 8 micrograms kg-1 min-1 alone produced a marked increase of the cardiac index from 2.47 to 3.47 litre min-1 m-2 but only small changes in heart rate (from 65 to 68 beat min-1). This improvement in cardiac performance was accompanied by an increase of the mean pulmonary artery pressure from 10.9 to 21.3 mm Hg and in the left ventricular filling pressure from 6.1 to 13.8 mm Hg with unchanged systemic and pulmonary vascular resistance. Mean arterial pressure increased from 72 to 103 mm Hg. Simultaneous infusion of dopamine (8 micrograms kg-1 min-1) and nitroglycerin (mean dose 0.5 microgram 21.3 to 14.4 mm Hg) and of left ventricular filling pressure (from 13.8 to 7.9 mm Hg). Cardiac index (from 3.47 to 3.34 litre min-1 m-2) and mean arterial pressure (from 103 to 95 mm Hg) were not reduced to the same extent by the addition of nitroglycerin. The combined treatment of dopamine with nitroglycerine seems to be of value in patients with pre-existing high left ventricular filling pressure or with pulmonary hypertension.

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“…Besides the well-known vasoconstriction mediated by alpha receptors, there are two vasodilating components, one of the two being mediated by beta receptors. Since that time, numerous investigators have elucidated the specific dopamine effects on the heart and the peripheral circulation (1,6,10,11,16,20,23,26,27,35,37)~ It has been demonstrated that low doses of dopamine stimulate the beta adrenergic receptors, while high doses also stimulate the alpha receptors (10,15,34,38). When referred to the same increase in arterial pressure, the venous effect of dopamine is stronger than that of norepinephrine and as strong as that of epinephrine.…”

Section: Sunzmarymentioning

confidence: 99%

Effects of dopamine on total peripheral resistance and integrated systemic venous blood volume in dogs

et al. 1980

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SunzmaryThe effect of dopamine on the peripheral circulation was investigated in 19 anaesthetized dogs with cardio-pulmonary bypass. Perfusion rate and both caval vein pressures were kept constant. Thus the peripheral effects could be studied in the absence of any direct or indirect influences from the heart. Dopamine was infused over a time span of 3 min in 61 experiments. In dogs with intact arterial pressoreceptors, doses of 25 and 50 ~g/kg effected a decrease in mean arterial pressure of up to 7 mmHg; doses of 100 and 200 ~g/kg effected initially a decrease and subsequently a dose-related increase in mean arterial pressure by up to 33 mmHg. Venous blood volume decreased by up to 4.2 ml/kg. In dogs with denervated arterial pressoreceptors, the arterial and venous effects were more pronounced. After beta receptor blockade, the initially effected decrease in mean arterial pressure was unchanged, whereas the subsequent increase in mean arterial pressure was significantly more pronounced.It is concluded that three components of action are involved in the effect of dopamine on the peripheral resistance vessels. Besides the well-known vasoconstriction mediated by alpha receptors, there are two vasodilating components, one of the two being mediated by beta receptors. Moreover, dopamine effects a constriction of the integrated systemic venous bed. When referred to the same increase in arterial pressure, the venous effect of dopamine is stronger than that of norepinephrine and as strong as that of epinephrine. The venoconstriction must lead to an increased venous return and hence to an increase in cardiac output and arterial pressure. The beneficial effect of dopamine in the treatment of shock appears to be due to the advantageous combination of these components of action.

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Der Einflu� von Dopamin auf H�modynamik und Nierenfunktion bei der schweren Herzinsuffizienz des Menschen

Cited by 35 publications

References 28 publications

Effect of dopamine on regional pulmonary perfusion.

Effect of dopamine on regional pulmonary perfusion.

Haemodynamic Effects of Dopamine and Dopamine Combined With Nitroglycerin in Patients Subjected to Coronary Bypass Surgery

Effects of dopamine on total peripheral resistance and integrated systemic venous blood volume in dogs

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