. Dopamine-1 receptor stimulation impairs intestinal oxygen utilization during critical hypoperfusion. Am J Physiol Heart Circ Physiol 284: H668-H675, 2003; 10.1152/ ajpheart.00636.2002.-Effects of a dopamine-1 (DA-1) receptor agonist on systemic and intestinal oxygen delivery (Ḋ O2)-uptake relationships were studied in anesthetized dogs during sequential hemorrhage. Control (group 1) and experimental animals (group 2) were treated similarly except for the addition of fenoldopam (1.0 g ⅐ kg Ϫ1 ⅐ min Ϫ1 ) in group 2. Both groups had comparable systemic critical Ḋ O2 (Ḋ O2crit), but animals in group 2 had a higher gut Ḋ O2crit (1.12 Ϯ 1.13 vs. 0.80 Ϯ 0.09 ml ⅐ kg Ϫ1 ⅐ min Ϫ1 , P Ͻ 0.05). At the mucosal level, a clear biphasic delivery-uptake relationship was not observed in group 1; thus oxygen consumption by the mucosa may be supply dependent under physiological conditions. Group 2 demonstrated higher peak mucosal blood flow and lack of supply dependency at higher mucosal Ḋ O2 levels. Fenoldopam resulted in a more conspicuous biphasic relationship at the mucosa and a rightward shift of overall splanchnic Ḋ O2crit despite increased splanchnic blood flow. These findings suggest that DA-1 receptor stimulation results in increased gut perfusion heterogeneity and maldistribution of perfusion, resulting in increased susceptibility to ischemia. oxygen supply dependency; splanchnic ischemia; vasodilators AT A GIVEN LEVEL OF METABOLIC demand, systemic oxygen consumption is maintained constant despite moderate changes in systemic oxygen delivery (Ḋ O 2 ) (6,14,25,30,31). This is accomplished by changes in peripheral oxygen extraction, with a consequent decrease in mixed venous oxygen content. However, once Ḋ O 2 falls below a critical threshold, parallel decreases in oxygen uptake (V O 2 ) are observed. This "oxygen supply dependency" is accompanied by maximal tissue oxygen extraction, development of anaerobic metabolism, and venous hypercarbia (12,14).The splanchnic circulation is particularly susceptible to ischemia during shock (1, 17). This regional ischemia is thought to play an important role in the development of multiple-system organ failure by activation of a systemic inflammatory response (22,35). In an effort to prevent or decrease gut ischemia, numerous gut-directed therapeutic approaches have been attempted with conflicting results (12). To date, clinical attempts to improve gut perfusion have focused mainly on the use of vasoactive drugs (16,20,21). However, the lack of splanchnic selectivity by these vasoactive agents could yield unwanted effects on gut oxygenation and desired outcomes. The most "gut-selective" vasoactive agent in common clinical use is dopamine given at relatively low doses. In animal models, low-dose dopamine infusions accelerate the onset of gut ischemia, impair gut oxygen extraction, and decrease gut V O 2 (9, 32). It is unclear from these data whether the adverse effects of low-dose dopamine are secondary to redistribution of flow within the gut or due to dopamine-induced alterations i...