Deliberate Increase of Oxygen Delivery in the Perioperative Period

This case focuses on increasing the amount of oxygen delivered to the surgical patient during the perioperative period by asking the question: Does the deliberate increase in oxygen delivery with the use of perioperative dopexamine reduce mortality and morbidity in high-risk surgical patients? Dopexamine is a dopamine analogue that produces peripheral vasodilation and an increase in cardiac index without significant increases in myocardial oxygen consumption. High-risk surgical patients were randomized to control or protocol limbs of the study. This randomized controlled study demonstrated a significant reduction in mortality and morbidity when dopexamine was used to increase oxygen delivery during the perioperative period in high-risk surgical patients.

1993 ◽  
Vol 21 (1) ◽  
pp. 64-69 ◽  
Author(s):  
GUSTAVO LUGO ◽  
DANIEL ARIZPE ◽  
GUILLERMO DOMINGUEZ ◽  
MARICELA RAMIREZ ◽  
ORLANDO TAMARIZ

1995 ◽  
Vol 23 (4) ◽  
pp. 478-484 ◽  
Author(s):  
O. Boyd ◽  
G. Lamb ◽  
C. J. Mackay ◽  
R. M. Grounds ◽  
E. D. Bennett

Peri-operative increase of oxygen delivery has been shown to reduce mortality in high-risk surgical patients. This study compares the effectiveness of dopexamine and dobutamine when used to increase cardiac output as part of a regimen to increase oxygen delivery. Sixteen surgical patients were randomly allocated to receive either dopexamine or dobutamine, which was increased to a stable dose defined as either oxygen delivery index >600 ml/min/m2, or tachycardia >20% above baseline, other dysrhythmias or angina. At this “stable” dose there were significant increases in cardiac index (2.4±0.2 vs3.7± 0.3 l/min/m2) and oxygen delivery (380±73 vs 579±40 ml/min/m2) in the dopexamine group (P< 0.05); but not the dobutamine group. Five out of eight patients receiving dopexamine and three out of eight receiving dobutamine reached target oxygen delivery Three dobutamine patients, but no dopexamine patients, had angina or dysrhythmias. In preoperative high-risk surgical patients, dopexamine can allow greater increases in oxygen delivery than dobutamine, due to cardiac effects that limit the dobutamine infusion rate.


Critical Care ◽  
2006 ◽  
Vol 10 (3) ◽  
Author(s):  
Suzana M Lobo ◽  
Francisco R Lobo ◽  
Carlos A Polachini ◽  
Daniela S Patini ◽  
Adriana E Yamamoto ◽  
...  

1997 ◽  
Vol 23 (1) ◽  
pp. 85-90 ◽  
Author(s):  
J. F. Guest ◽  
O. Boyd ◽  
W. M. Hart ◽  
R. M. Grounds ◽  
E. D. Bennett

2009 ◽  
pp. 654-664
Author(s):  
S. M. Lobo ◽  
E. Rezende ◽  
F. Suparregui Dias

Sign in / Sign up

Export Citation Format

Share Document