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British Journal of Anaesthesia, Vol 77, Issue 6 753-757, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Lack of specific renal haemodynamic effects of different doses of dopamine after infrarenal aortic surgery

ARJ. Girbes, A. G. Lieverse, A. J. Smit, D. J. van Veldhuisen, J. H. Zwaveling, S. Meijer and W. D. Reitsma
Department of Surgery, Surgical Intensive Care and Department of Cardiology, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, Netherlands; Department of Internal Medicine, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, Netherlands

Dopamine is administered frequently in the operating theatre and intensive care unit patients undergoing mechanical ventilation with the aim of specifically enhancing renal blood flow. In an uncontrolled, open study, we administered sequentially different doses of dopamine (0, 2, 4, 8 and 0 microgram kg-1 min-1) during a 1-h period each. Systemic haemodynamic and renal haemodynamic variables were measured simultaneously using a pulmonary artery catheter and radiopharmaceuticals, respectively. We studied seven haemodynamically stable patients (mean age 66 yr), with a serum creatinine concentration < 160 microgramsmol litre-1, after elective infrarenal abdominal aortic reconstruction. All patients received extradural analgesia with bupivacaine and sufentanil, and none had a previous history of heart failure. Dopamine induced a dose-dependent increase in cardiac index which returned to baseline after cessation of the dopamine infusion. Glomerular filtration rate (GFR) increased with all doses of dopamine, whereas renal blood flow (RBF) increased significantly only with the 2- and 4-microgram kg-1 min-1 doses. However, the ratio RBF/cardiac output remained unchanged with the 2- and 4-microgram kg-1 min-1 doses, but decreased with 8 micrograms kg-1 min-1 from 14 (1.5)% to 10 (1.3)%. We conclude that dopamine increased RBF and GFR as a result of an increase in cardiac output.
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