Haemodynamic and pharmacokinetic study of intravenous fenoldopam in patients with hepatic cirrhosis.

Vlavianos, Panagiotis; Polson, Rex J.; Settin, Ahmad; Glover, June L.; Westaby, David; Williams, Roger

doi:10.1111/j.1365-2125.1990.tb03597.x

Cited by 8 publications

(1 citation statement)

References 17 publications

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“…This discrepancy has been demonstrated for dopamine (8,11,12) and dopexamine (10,13), whereas for fenoldopam little information is available. Under compromised cardiocirculatory conditions, fenoldopam may elicit beneficial splanchnic effects [e.g., increase splanchnic perfusion during hemorrhage (4) and heart failure (14)], maintain splanchnic conditions [e.g., during endotoxemia (12), after cardiopulmonary bypass (15) and in hypertensive states (16)], or even exert negative splanchnic effects [e.g., increase portal venous pressure (17) and decrease liver function (18) …”

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confidence: 99%

Dopamine under α1-blockade, but not dopamine alone or fenoldopam, increases depressed gastric mucosal oxygenation*

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Schindler

et al. 2004

Critical Care Medicine

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During compromised cardiocirculatory conditions, alpha1-receptor activation during dopamine infusion prevented an increase in gastric mucosal oxygenation. Furthermore, selective DA1-stimulation (by fenoldopam) was insufficient to overcome the PEEP-induced depression of microHbO2. The responses of gastric mucosal oxygenation did not parallel changes in systemic oxygen transport. These findings were independent of fluid resuscitation.

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confidence: 99%

Dopamine under α1-blockade, but not dopamine alone or fenoldopam, increases depressed gastric mucosal oxygenation*

Schwarte

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Schindler

et al. 2004

Critical Care Medicine

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Selective dopamine DA1 stimulation with fenoldopam in cirrhotic patients with ascites: A systemic, splanchnic and renal hemodynamic study

et al. 1991

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We studied the effects of fenoldopam, a selective dopamine DA1 agonist on systemic and splanchnic hemodynamics, renal blood flow and sodium excretion in 12 patients with alcoholic cirrhosis and ascites. Hepatic, azygos and renal veins were catheterized before and after intravenous administration of fenoldopam, 0.05 micrograms/kg/min for 1 hr and increased to 0.1 micrograms/kg/min for another hour. Mean arterial pressure progressively decreased (from 83 +/- 7 to a minimum of 77 +/- 8 mm Hg 100 min after starting the infusion) but returned to baseline level at 120 min. Plasma norepinephrine and renin activity increased (respectively from 567 +/- 297 to 919 +/- 375 pg/ml, p less than 0.05, and from 17 +/- 14 to 23 +/- 15 ng/ml/hr, p less than 0.05). Renal blood flow, urine output or sodium excretion did not change. Sodium output decreased at 1 hr from 6.9 mumol/min to 4.0 mumol/min, p less than 0.05. Both hepatic venous pressure gradient and azygos blood flow significantly increased by 21%. We conclude that the acute administration of fenoldopam did not improve renal hemodynamics or function in patients with cirrhosis and ascites. In addition, dopamine DA1 agonism caused further increases in norepinephrine concentration and plasma renin activity. Portal pressure also increased, probably because of an increase in mesenteric blood flow. These results question the renal benefit and raise concern about the use of dopamine agonists in patients with cirrhosis and ascites.

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Use of Dopaminergic Agonists for Renal Protection in the ICU

Murray¹

2003

Intensive Care Medicine

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Haemodynamic and pharmacokinetic study of intravenous fenoldopam in patients with hepatic cirrhosis.

Cited by 8 publications

References 17 publications

Dopamine under α1-blockade, but not dopamine alone or fenoldopam, increases depressed gastric mucosal oxygenation*

Dopamine under α1-blockade, but not dopamine alone or fenoldopam, increases depressed gastric mucosal oxygenation*

Selective dopamine DA1 stimulation with fenoldopam in cirrhotic patients with ascites: A systemic, splanchnic and renal hemodynamic study

Use of Dopaminergic Agonists for Renal Protection in the ICU

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