Is dopexamine superior to dopamine in the treatment of multiple trauma patients—A prospective, double-blind, randomised study

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• 作者：Christian Probst ; Frank Hildebr ; Martijn van Griensven ; Hellmut Baur ; Lutz Mahlke ; Christian Krettek ; Hans-Christoph Pape ; Martin Rolf Wolfgang Grotz
• 关键词：Dopexamine ; Dopamine ; Polytrauma ; Multiple organ failure ; Intramucosal pH ; Monoethylglycinexylidide ; Intensive care course ; Splanchnic oxygenation
• 刊名：Injury
• 出版年：2010
• 出版时间：May 2010
• 年：2010
• 卷：41
• 期：5
• 页码：499-505
• 全文大小：233 K

文摘

Background

The goal of this prospective, randomised, double-blind clinical trial study was to assess the effects of dopexamine hydrochloride on organ failure, inflammatory mediators and splanchnic oxygenation in blunt multiple trauma patients at high risk of multiple organ dysfunction syndrome (MODS).

Methods

We performed a prospective randomised controlled trial on 30 consecutive blunt multiple trauma patients with ISS ≥ 16, age 18–60 years and initial blood pressure ≥120 mmHg initially admitted to our level I trauma centre. Patients were randomised to treatment with dopamine (n = 15) or dopexamine (n = 15) for 48 h after admission. Outcome in terms of mortality, MODS, splanchnic perfusion, complications, duration of stay was statistically analysed.

Results

Dopexamine treatment was associated with impaired organ function and an increased duration of ventilation and ICU stay compared with patients who received dopamine treatment. The acute inflammatory response was increased in the Dopexamine group while a decreased pHi and MEGX formation and increased serum lactate levels were measured.

Conclusions

The indication to use dopexamine hydrochloride appears questionable. In the absence of an antiinflammatory effect, dopexamine demonstrated a disadvantageous ICU course in regards to the organ function and the duration of treatment. In addition, a decreased pHi and MEGX formation suggested a deterioration of splanchnic oxygenation.