British Journal of Anaesthesia, 2003, Vol. 91, No. 5 615-618
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia
Should perioperative management target oxygen delivery?
1 Department of Anaesthetics, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 5SA, UK E-mail: simon.mackenzie@luht.scot.nhs.uk
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Several strategies have been proposed to improve outcome after surgery. One of these is the use of fluids and catecholamines to achieve supra-normal oxygen delivery, an approach variously termed goal directed therapy, pre-optimization, and haemodynamic optimization. This attractive concept is the basis of the study by Stone and colleagues,1 published in this issue of the journal. In this placebo controlled trial, patients who were given dopexamine at a rate of 0.25 µg kg1 min1 during surgery and for 24 h thereafter had a significantly higher cardiac index than patients given placebo, but morbidity and mortality were unaffected. Fluid therapy was used to increase stroke volume, measured using an oesophageal Doppler, before commencing the dopexamine. Oxygen delivery was not measured but the authors estimate, that it would have been between 500 and 550 ml min1 m2 in the placebo group and over 600 ml min1 m2 in the dopexamine group, is
Dopexamine
Oxygen delivery
Implications for clinical practice
Addressing the unanswered questions
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P. Older, A. Hall, M. P. W. Grocott, E. Chaloner, M. G. Mythen, and S. J. Mackenzie Should perioperative management target oxygen delivery? Br. J. Anaesth., April 1, 2004; 92(4): 597 - 598. [Full Text] [PDF] |
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P. J. M. Bayly and R. J. T. Wilson Effect of adding dopexamine to intraoperative volume expansion in patients undergoing major elective abdominal surgery Br. J. Anaesth., April 1, 2004; 92(4): 598 - 599. [Full Text] [PDF] |
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