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British Journal of Anaesthesia, 1995, Vol. 74, No. 5 583-590
© 1995 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

Cardiovascular responses to graded doses of three catecholamines during lactic and hydrochloric acidosis in dogs{dagger}

Y.-G. HUANG, MD, K. C. WONG, MD, PHD, W.-H. YIP, MD, S. W. McJAMES, BS and N. L. PACE, MD

Department of Anesthesiology, University of Utah School of Medicine Salt Lake City, UT 84132, USA.
Peking Union Medical College Hospital Beijing, China
Kaohsiung Medical College Hospital Taiwan

Correspondence to K. C. W.

We have studied the cardiovascular effects of incremental doses of three catecholamines in dogs subjected to lactic (LAC) and hydrochloric (HCl) acidosis. Fifty-four dogs were allocated randomly to one of three groups: control, LAC and HCl acidosis (n = 18 each group). In the acidotic models, 2 mol litre–1 of lactic acid (4 ml kg–1 h–1 or 2 mol litre–1 of HCl (1 ml kg–1 h–1) was infused i.v. until arterial pH was reduced to 7.00±0.1. Within each group, six dogs received one of three different drugs in logarithmically incremental doses: adrenaline 0.1, 0.2, 0.4, 0.8, 1.6, 3.2 µg kg–1 min–1, noradrenaline 0.1, 0.2, 0.4, 0.8, 1.6, 3.2 µg kg–1 min–1 and dobutamine 5, 10, 20, 40, 80, 160 µg kg–1 min–1 Cardiovascular variables were monitored, with periodic measurements of plasma electrolyte and lactate concentrations. The pH reduction induced by HCl or lactic acid was associated with a statistically significant increase in mean pulmonary arterial pressure (MPAP), prominent especially in the LAC group where MPAP increased from mean 18 (SD 5) to 27 (6) mm Hg. In the acidotic models, the reduction in myocardial responsiveness to adrenaline or noradrenaline was more prominent than that for the control for corresponding doses of drugs. In the LAC group mean cardiac index decreased significantly from 5.2 (1.8) to 2.2 (0.7) litre min–1 m–2 after infusion of adrenaline 3.2 µg kg–1 min–1 and decreased from 5.1 (1.1 to 2.4 (0.9) litre min–1 m–1 after infusion of noradrenaline 3.2 µg kg–1 min–1. In contrast, dobut amine showed dose-dependent increases in cardiac index and heart rate in control, as well as acidotic groups. The acute HCl acidosis induced greater hyperkalaemia than the lactic acidosis. (Br. J. Anaesth. 1995; 74: 583–590)

{dagger}Presented in part at the 1992 ASA Congress, New Orleans, USA and at the Anesthesia and Cardiovascular Disease Symposium, Milwaukee, WI, USA, September 1993.


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