Circulation, Vol 57, 378-384, Copyright © 1978 by American Heart Association
PA Steen, JH Tinker, JR Pluth, , DA rst and S Tarhan
Hemodynamic effects of dobutamine and dopamine (both 5, 10, 15
microgram/kg/min) and epinephrine (0.04 microgram/kg/min) were studied
immediately following cessation of cardiopulmonary bypass in 34 patients
with preoperative evidence of left ventricular dysfunction. Significant
increases in mean cardiac index were seen with dobutamine (15, 25, and 26%
respectively), and epinephrine (30%). The largest increases occurred with
dopamine (44, 53, and 64 percent respectively). Responses varied from
patient to patient, however. Seven patients developed marked output
increases without concomitant increases in arterial pressure, whereas seven
others showed "satisfying" increases in arterial pressure without
appreciable output increases. Heart rate increases were small and few
arrhythmias were noted. We conclude that dopamine, epinephrine, and
dobutamine all are effective inotropic agents during the immediate
post-bypass period, with variations discussed in detail. None possess the
disturbing chronotropic and arrhythmogenic effects of isoproterenol
(previously studied). Efficacy of administration of inotropic drugs seems
best assessed by serial output measurements during this period.
ARTICLES
Efficacy of dopamine, dobutamine, and epinephrine during emergence from cardiopulmonary bypass in man
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