Comparison of norepinephrine-dobutamine to dopamine alone for splanchnic perfusion in sheep with septic shock.

AIM: To compare the effect of norepinephrine-dobutamine with dopamine alone on
splanchnic perfusion in sheep with septic shock.
METHODS: Twenty sheep with septic shock induced by lipopolysaccharides were
divided into two groups. When systolic pressure decreased by 5.3 kPa, basic
values of hemodynamic parameters and intestinal intramucosal pH (pHi) were
recorded. Each group was randomized to receive an intravenous infusion of
norepinephrine-dobutamine or dopamine, and titrated to obtain mean arterial
pressure (MAP) > 12 kPa with an optimal cardiac preload. Hemodynamic parameters
and mucosal pHi were repeated at 1, 2, 3, and 4 h after basic measurement.
RESULTS: After norepinephrine-dobutamine or dopamine infusion, MAP, cardiac
output, and oxygen delivery increased in all animals compared with basic values
in both groups (P < 0.05). Compared with baseline values, lactate concentrations
decreased at 3 h and 4 h [from (4 +/- 2) mmol/L to (2 +/- 1) mmol/L] in the
norepinephrine-dobutamine group (P < 0.05 ). Arterial lactate concentrations had
no change in dopamine group, but arterial pH decreased from 7.40 +/- 0.05 to 7.26
+/- 0.06 at 1 h (P < 0.05 ). No difference in pHi was found in dopamine group,
but in the norepinephrine-dobutamine group, compared with baseline, pHi increased
from 7.19 +/- 0.04 to 7.36 +/- 0.07 at 3 h (P < 0.05).
CONCLUSION: Both norepinephrine-dobutamine and dopamine alone could improve
systemic hemodynamics in sheep with septic shock, but norepinephrine-dobutamine
was better than dopamine on splanchnic perfusion.