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Clinical Trial
. 2004 Jul 1;122(4):141-6.
doi: 10.1590/s1516-31802004000400002. Epub 2004 Nov 9.

Hemodynamics and renal function during administration of low-dose dopamine in severely ill patients

Cláudia Nathalie Pereira  1 , Flávia Ribeiro Machado, Hélio Penna Guimarães, Ana Paula Resque Senna, José Luiz Gomes do Amaral
Affiliations
Clinical Trial

Hemodynamics and renal function during administration of low-dose dopamine in severely ill patients

Cláudia Nathalie Pereira et al. Sao Paulo Med J. .

Abstract
in English, Portuguese

Context: Although a large number of studies have been performed regarding the renal and hemodynamic effects of the infusion of low-dose dopamine (LDD) in severely ill patients, there is still controversy on this subject.

Objective: To evaluate the effects of dopamine (2 microg/kg/min) on systemic hemodynamics (lowest mean arterial pressure, MAP, highest heart rate, HR, central venous pressure, CVP), creatinine clearance (CLcr), diuresis and fractional sodium excretion (FENa+).

Type of study: A non-randomized, open, prospective clinical trial.

Setting: An intensive care unit in a tertiary university hospital.

Participants: 22 patients with hemodynamic stability admitted to the intensive care unit.

Procedures: Patients were submitted to three two-hour periods: without dopamine (P1), with dopamine (P2) and without dopamine (P3).

Main measurements: The above mentioned variables were measured during each period. CLcr was assessed based upon the formula U x V/P, where U is urinary creatinine (mg/dl), V is diuresis in ml/min and P is serum creatinine (mg/dl). FENa+ was calculated based upon the formula: urinary sodium (mEq/l) x P/plasma sodium (mEq/l) x U) x 100. Results were presented as mean and standard deviation. The Student t test was used and results were considered significant if p was less than 0.05.

Results: Twelve patients (seven males and five females) were included, with a mean age of 55.45 years. There was no significant variation in MAP, HR, CVP, CLcr or FENa+ with a dopamine dose of 2 microg/kg/min. On the other hand, diuresis significantly increased during P2, from 225.4 to 333.9 ml.

Conclusion: Infusion of 2 microg/kg/min of dopamine for 2 hours increases diuresis. At the doses studied, dopamine does not induce significant alterations in MAP, HR, CVP, CLcr and FENa+.

CONTEXTO:: Apesar do grande número de trabalhos sobre os efeitos renais e hemodinâmicos de doses baixas de dopamina em pacientes graves, ainda existe muita controvérsia a respeito.

OBJETIVOS:: Esse estudo objetivou avaliar os efeitos de dopamina (2 mcg/kg/min) na hemodinâmica (máxima pressão arterial média, PAM, freqüência cardíaca máxima, FR, pressão venosa central, PVC, clearance de creatinina, CLcr, diurese e fração de excreção de sódio, FENa+).

TIPO DE ESTUDO:: Estudo clínico não randomizado, aberto, prospectivo.

LOCAL:: Uma unidade de terapia intensiva em hospital universitário terciário.

PARTICIPANTES:: 22 pacientes com estabilidade hemodinâmica admitidos na Unidade.

PROCEDIMENTOS:: Os pacientes foram submetidos a três períodos de duas horas de duração cada um: sem dopamina (P1), com dopamina (P2) e sem dopamina (P3).

PRINCIPAIS VARIÁVEIS ESTUDADAS:: As variáveis acima mencionadas foram medidas em cada um dos períodos. CLcr foi medido baseado na fórmula U.V/P, onde U é a creatinina urinária (mg/dl), V é a diurese em ml/min e P é a creatinina sérica (mg/dl). FENa+ foi calculado baseado na fórmula: sódio urinário (mEq/l) x P/sódio plasmático (mEq/l) x U) x 100. Os resultados foram apresentados como média e desvio padrão. O teste t de Student foi utilizado e os resultados considerados significativos se o valor de p fosse menor que 0,05.

RESULTADOS:: 12 pacientes (sete homens e cinco mulheres) foram incluídos, com a idade média de 55.45 anos. Não houve nenhuma variação na PAM, FR, PVC, CLcr ou FENa+ com o uso de dopamina na dose de 2 mcg/kg/min. Entretanto, a diurese aumentou significativamente no P2, de 225.4 para 333.9 ml.

CONCLUSÕES:: A infusão de 2 mcg/kg/min de dopamina durante duas horas aumenta a diurese. Nas doses estudadas, a dopamina não induziu alterações significativas na PAM, FR, PVC, CLcr e FENa+.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. Diuresis (in ml) during the three infusion periods (P1, P2, and P3) in 22 patients admitted in na intensive care unit in São Paulo. Results are expressed in means.
See this image and copyright information in PMC

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