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Intensive Care Medicine

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01-06-2004 | Original

Effects of dopexamine, dobutamine or dopamine on prolactin and thyreotropin serum concentrations in high-risk surgical patients

Authors: Thomas Schilling, Matthias Gründling, Christof M. Strang, Klaus-Uwe Möritz, Werner Siegmund, Thomas Hachenberg

Published in: Intensive Care Medicine | Issue 6/2004

Abstract

Objectives

Catecholamines are often used for optimisation of cardiac index and oxygen delivery in high-risk surgical patients; however, infusions of dopamine and dopexamine are associated with dose-dependent hypophysiotropic and thyreotropic properties. The objective was to compare endocrine effects of equipotent inotropic doses of dopexamine, dobutamine and dopamine on prolactin and thyreotropin release perioperatively.

Design

A prospective, randomised, blinded clinical trial.

Setting

Adult surgical intensive care unit in a university hospital.

Patients

Thirty male patients (ASA III) undergoing elective major abdominal surgery.

Interventions

Patients were randomised to receive dopexamine (DX, n=10), dobutamine (DO, n=10) or dopamine (DA, n=10) on the first postoperative day for 8 h.

Measurements and results

All patients received a catecholamine infusion in doses adjusted to increase cardiac index by 35% within the first hour. Blood samples were obtained and prolactin and thyreotropin serum concentrations were determined by radioimmunoassays. Mean doses of dopexamine, dobutamine and dopamine used were 0.73±0.27, 4.06±1.95 and 5.0±1.84 µg kg⁻¹min⁻¹, respectively. Cardiac index was increased by 36% (DX group), 38% (DO group) and 38% (DA group). Alterations of oxygen delivery and oxygen consumption were not significantly different between the study groups. Dopexamine and dobutamine had no hypophysiotropic effects. In contrast, dopamine suppressed prolactin and thyreotropin secretion with a maximal effect after 4 h. After dopamine withdrawal, a rebound release of prolactin and thyreotropin was observed.

Conclusions

In high-risk surgical patients dopexamine or dobutamine produced fewer effects on prolactin and thyreotropin serum concentrations in comparison with DA when used in equivalent dosages.

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Title: Effects of dopexamine, dobutamine or dopamine on prolactin and thyreotropin serum concentrations in high-risk surgical patients
Authors: Thomas Schilling
Matthias Gründling
Christof M. Strang
Klaus-Uwe Möritz
Werner Siegmund
Thomas Hachenberg
Publication date: 01-06-2004
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 6/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-004-2279-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of dopexamine, dobutamine or dopamine on prolactin and thyreotropin serum concentrations in high-risk surgical patients

Abstract

Objectives

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

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