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Dopexamine and its role in the protection of hepatosplanchnic and renal perfusion in high-risk surgical and critically ill patients

Lookup NU author(s): Dr Christopher Snowden


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Background. Dopexamine is increasingly being used in high-risk surgical and critically ill patients to preserve hepatosplanchnic and renal perfusion. This systematic review of randomized controlled trials was undertaken to investigate the clinical evidence for using dopexamine in this role. Methods. Data sources included Medline, Cochrane Library, EMBASE and CINAHL and reference lists of relevant articles. Randomized controlled trials which compared dopexamine treatment with a control group, in high-risk surgical and critically ill adult patients and with primary outcome measures designed to assess hepatosplanchnic and renal perfusion were included. Articles not published in English were excluded. Results. Twenty-one trials were selected from the literature search. The results suggest that dopexamine may protect against colonic mucosal damage in patients undergoing abdominal aortic surgery and may improve gastric mucosal pHi in general surgical patients, especially those with preoperative gastric mucosal pHi measurements < 7.35 and those undergoing pancreatico-duodenectomy surgery. Dopexamine may have beneficial effects on renal perfusion in patients undergoing cardiac surgery but appears to have little or no benefit on gastric mucosal pHi in the same patient population. In critically ill patients none of the studies demonstrated a beneficial effect of dopexamine on either hepatosplanchnic or renal perfusion. Conclusion. The evidence provided by the existing studies is both inadequate and inconsistent. There is insufficient evidence to offer reliable recommendations on the clinical use of dopexamine for the protection of either hepatosplanchnic or renal perfusion in high-risk surgical patients. Furthermore, there is no current evidence to support a role for dopexamine in protecting either hepatosplanchnic or renal perfusion in critically ill patients.

Publication metadata

Author(s): Renton MC, Snowden CP

Publication type: Article

Publication status: Published

Journal: British Journal of Anaesthesia

Year: 2005

Volume: 94

Issue: 4

Pages: 459-467

ISSN (print): 0007-0912

ISSN (electronic): 1471-6771

Publisher: Oxford University Press


DOI: 10.1093/bja/aei072


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