Dopamine Hydrochloride

Effect of Dopamine in Cardiac Patients after Open Heart Surgery by Dr A Chauve, Dr A Castro and Dr F Fontan (Clinique Chirurgicale des Maladies Cardiaques, Hopital du Tondu, Bordeaux Cedex, France) The efficiency of dopamine upon the haemodynamic status of patients who underwent open heart surgery was assessed by a systematic evaluation in the postoperative intensive care unit of the Clinique Chirurgicale des Maladies

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calculated for each dosage. The mean of parameter values during perfusion of dopamine was then calculated for the 15 patients and for each dosage and compared to values at rest. Their variations were statistically analysed. Patients: The experiment was made in 15 patients (11 males, 4 females) with adequate postoperative hmmodynamic status. The average age was 48.2 years with a range of 15 to 66 years. Four had venous aorto-coronary by-pass, 4 had a closure for an atrio-septal defect, 7 had valve replacements; 5 aortic, one mitral and one combined aortic and mitral valves.

Cardiaques.

Results Adverse reactions: Patients did not complain of any pain or discomfort during the administration Material and Methods Hwmodynamic parameters: In all patients, sys- of the drug but they had a low level of conscioustemic, left atrial and pulmonary artery pressures, ness and complete ventilatory support. With 5 cardiac rhythm and frequency, cutaneous tem- gik/kg per min dopamine two patients suffered perature, and urinary output were monitored. cardiac arrhythmias (Table 1): one of them had Cardiac output was measured by a thermodilution sinus tachycardia after 30 minutes which dismethod using a probe placed in the pulmonary appeared in 5 minutes after the perfusion had artery through the right atrium. Pulmonary and been stopped. This patient was not excluded from the protocol. The other patient had a burst of systemic resistances were calculated. Protocol: The study began one or two hours after premature ventricular beats and a high blood the patient entered the recovery room when pressure level after 60 minutes; perfusion of restoration of the blood volume was completed dopamine was therefore stopped. It was stopped and hamodynamic parameters remained stable. at 60 minutes in 2 other patients because there Each successive dosage of 5, 10, 15 ig/kg per min was a break in the intrapulmonary probe used for dopamine was studied during 90 minutes and cardiac output measurements. Perfusion of 10 jLg/kg per min dopamine was hmmodynamic parameters measured 3 times (every 30 minutes). To prevent interference of one carried out in 12 patients: 5 suffered cardiac study with another, patients were left free of arrhythmias. Dopamine perfusion had to be stopped in 3 patients for sinus tachycardia after dopamin between each study. Results: For each patient, the mean value of 60 minutes of perfusion. Perfusion of dopamine measurements performed every 30 minutes was had to be stopped in 2 patients at 30 minutes because of a burst of premature ventricular beats; and in 2 patients because of impairment of the Table 1 probe used for cardiac output measurements. Number of patients with rhythm disturbances Perfusion of 15 jg/kg per min was carried out during administration of dopamine in 8 Patients: 2 suffered arrhythmias. There was Dosage (tLg/kg/min) sinus tachycardia in one, and premature ventrii5 5 10 cular beats in the other one; the administration 1/15 3/12 1/8 Sinus tachycardia of dopamine was interrupted in these 2 patients Premature ventricular beats 1/15 2/12 1/8 as soon as rhythm disturbances appeared.

Table 2 Hiemodynamic changes induced by dopamine: mean values of data obtained from 15 patients with good cardiac function

Dopamine S pLg/kg/min

Heartrate(beats/min) Left atrial pressure (mmHg) Pulmonary artery pressure (mmHg) Cardiac index (1/min/m')

Urinary output (ml/hour) Peripheral resistances (u/mi') Pulmonary resistances (u/mi') Skin temperature (0°C)

Before After 96 108.1 9.2 9.1

13.63 15 2.94 3.67 117.33 214.33 29.1 23.35 1.46 1.24 29.06 30.9

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Effect of dopamine in cardiac patients after open heart surgery.

Dopamine Hydrochloride Effect of Dopamine in Cardiac Patients after Open Heart Surgery by Dr A Chauve, Dr A Castro and Dr F Fontan (Clinique Chirurgi...
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