Effects of dopamine in lung-transplanted pigs at 32 degrees C

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Abstract

BACKGROUND: We have used hypothermia successfully in patients with acute respiratory failure after lung transplantation. However, we have observed that dopamine may cause a substantial decrease in mean arterial pressure (MAP) in hypothermic subjects. Furthermore, a dopamine-induced increase in pulmonary vascular resistance (PVR) has been reported in the literature, and this could aggravate the increase in PVR which is often seen both in the early postoperative phase after lung transplantation, and during hypothermia. We thus hypothesized that dopamine would decrease MAP and increase PVR in hypothermic lung-transplanted subjects. METHODS: Left single lung transplantation combined with right pneumonectomy was performed in 6 pigs anesthetized with ketamine and midazolam and muscle relaxed with pancuronium. After an observation period of 24 h, the effect of dopamine infused at 5 and 12 microg x kg(-1) x min(-1) was studied in normothermia (38 degrees C) and after cooling by cold-water immersion to 32 degrees C. RESULTS: Systemic vascular resistance index (SVRI) increased and cardiac index (CI) decreased in hypothermia. Dopamine decreased SVRI and increased CI, both in normothermia and at 32 degrees C. MAP decreased during infusion of dopamine in hypothermia. Dopamine had no effect on the pulmonary vascular resistance index (PVRI). CONCLUSION: The results suggest that dopamine may be used to increase cardiac output after lung transplantation in moderate hypothermia as well as in normothermia, but one should be aware that dopamine may cause a substantial decrease in blood pressure, depending on the prevailing hemodynamic conditions at the start of its administration.

Detaljer

Författare
Enheter & grupper
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Anestesi och intensivvård

Nyckelord

Originalspråkengelska
Sidor (från-till)715-721
TidskriftActa Anaesthesiologica Scandinavica
Volym43
Utgåva nummer7
StatusPublished - 1999
PublikationskategoriForskning
Peer review utfördJa