British Journal of Anaesthesia, Vol 79, Issue 3 357-362, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia
R. Germann, M. Haisjackl, B. Schwarz, N. Salak, E. Deusch, W. Pajk, H. J. Wolf, B. Riedmann and W. Hasibeder
Haemorrhage is associated with intestinal mucosal hypoxia and impaired gut
barrier function. Dopamine increases oxygen delivery to the intestinal
mucosa and may thus counteract haemorrhage-induced mucosal hypoxia. Jejunal
mucosal tissue oxygen tension (mucosal PO2) and jejunal oxygen saturation
of mucosal microvascular haemoglobin (mucosal HbO2) were measured in 14
anaesthetized pigs. Seven animals served as controls (group C) and seven
received continuous infusion of dopamine 16 micrograms kg-1 min-1 (group D)
while 45% of blood volume was removed in three equal increments.
Resuscitation was performed using shed blood and fluid. Mean arterial
pressure and systemic oxygen delivery decreasing significantly during
haemorrhage and returned to baseline after resuscitation in both groups.
Mucosal PO2 decreased from 4.4 to 1.7 kPa after haemorrhage (P < 0.01)
and further to 1.5 kPa after resuscitation (P < 0.01) in group C whereas
group D showed an increase from 3.9 to 5.9 kPa after the start of the
dopamine infusion (P < 0.05), but no significant difference from
baseline after haemorrhage (2.3 kPa) (ns) or resuscitation (3.1 kPa) (ns).
Mucosal HbO2 decreased from 52 to 32% after haemorrhage (P < 0.05) and
increased to near baseline (37%) (ns) after resuscitation in group C
whereas group D showed no significant changes from baseline (54%)
throughout the experiment. Comparison between groups showed higher mucosal
PO2 and HbO2 values for group D animals after the start of the dopamine
infusion (P < 0.05 each), after the first two steps of haemorrhage (P
< 0.01 each) and after resuscitation (P < 0.05 each). We conclude
that i.v. dopamine 16 micrograms kg-1 min-1 improved tissue oxygenation of
the small intestinal mucosa during moderate haemorrhage and subsequent
resuscitation.
LABORATORY INVESTIGATIONS
Dopamine and intestinal mucosal tissue oxygenation in a porcine model of haemorrhage
Department of Anaesthesia and General Intensive Care Medicine, University of Innsbruck, Anichstrabetae 35, A-6020 Innsbruck, Austria; Institute for Histology, University of Innsbruck, Anichstrabetae 35, A-6020 Innsbruck, Austria; First Department of Surgery, University of Innsbruck, Anichstrabetae 35, A-6020 Innsbruck, Austria
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