Effect of dopexamine on outcome after major abdominal surgery: A prospective, randomized, controlled multicenter study

Abstract

We conclude that dopexamine in doses that result in increased cardiac output and oxygen delivery after preoperative stabilization with fluids does not improve outcome after major abdominal surgery compared with fluids alone. Based on post hoc subgroup analysis and stratification according to the number of risk factors, we suggest that the concept should be further tested in patients at higher risk of complications or undergoing emergency surgery.

Evaluation of the Incidence of Post - anesthetic Complications in Recovery Unit of 9 - day Hospital in Torbat - e - Heydaryieh in 2016

“…Surgery can prevent countless mortality and reduce unpleasant complications of diseases, however, it can also expose the patient with several side effects (1,2).…”

Early management of the critically ill patient

“…However, beyond this there is evidence that in some patient groups outcome may be improved by targeting therapy towards specific goals. The absolute level of DO 2 that should be achieved in individual patients is controversial 4 . Fewer patients undergoing high-risk surgery will die if DO 2 is maintained above 600 ml/min/m 2 .…”

Revisão sistemática dos marcadores de otiminização da perfusão tecidual em ensaios clínicos aleatórios de cirurgias de alto risco

“…Study or Subgroup Bender, 1997Berlauk, 1991Bishop, 1995Boldt, 1998Bonazzi, 2002Boyd, 1993Chytra, 2007Conway, 2002Donati, 2007Fleming, 1992Gan, 2002Kapoor, 2008Lobo, 2000Lobo, 2006Lopes, 2007Mythen, 1995Pearse, 2005Polonen, 2000Sandham, 2003Shoemaker, 1988Shultz, 1985Sinclair, 1997Stone, 2003Takala, 2000Ueno, 1998Valentine, 1997Velmahos, 2000Venn, 2002Wakeling, 2005Wilson, 1999 Ziegler, 1997…”

“…Study or Subgroup Bishop, 1995Boldt, 1998Chytra, 2007Fleming, 1992Lobo, 2000Lobo, 2006Lopes, 2007Shoemaker, 1988Shultz, 1985 Total (95% CI) Total events Heterogeneity: Chi² = 3.01, df = 6 (P = 0.81); I² = 0% Test for overall effect: Z = 4.92 (P < 0.00001) Bender, 1997Berlauk, 1991Bishop, 1995Boldt, 1998Bonazzi, 2002Boyd, 1993Fleming, 1992Lobo, 2000Lobo, 2006Polonen, 2000Sandham, 2003Shoemaker, 1988Shultz, 1985Takala, 2000Ueno, 1998Valentine, 1997Velmahos, 2000Wilson, 1999 Ziegler, 1997…”

“…Total events Heterogeneity: Chi² = 36.08, df = 17 (P = 0.004); I² = 53% Test for overall effect: Z = 3.01 (P = 0.003) Bender, 1997Berlauk, 1991Bishop, 1995Boldt, 1998Bonazzi, 2002Boyd, 1993Fleming, 1992Kapoor, 2008Lobo, 2000Lobo, 2006Pearse, 2005Sandham, 2003Shoemaker, 1988Takala, 2000Ueno, 1998Valentine, 1997Velmahos, 2000Wilson, 1999 Total (95% CI) Total events Heterogeneity: Chi² = 29.12, df = 15 (P = 0.02); I² = 48% Test for overall effect: Z = 2.54 (P = 0.01) Heyland (1996), talvez a primeira revisão sistemática sobre estudos clínicos aleatórios designados para atingir valores supranormais de IC, IDO2 e IVO2 em pacientes críticos, atribuiu um rigor metodológico e selecionou apenas sete artigos de 64 identificados e concluiu que existe uma tendência não estatisticamente significativa de diminuição da taxa de mortalidade, risco Assim, há a necessidade de constante atualização científica para esse assunto tão complexo e contraditório, motivando esta revisão sistemática e todas as outras que ainda virão, na tentativa de elucidar, baseada na melhor evidência possível, todas as questões pertinentes (Cook and Guyatt 1994).…”