Effects of Dopexamine on Creatinine Clearance, Systemic Inflammation, and Splanchnic Oxygenation in Patients Undergoing Coronary Artery Bypass Grafting

Abstract

Ygenation, gastric mucosal pH (pHi), and mixed and hepatic venous plasma levels of endotoxin, interleukin-6 (IL-6), serum amyloid A (SAA), and C-reactive protein (CRP) in 44 patients scheduled for coronary artery bypass grafting. Patients were randomized to receive continuous infusions of 0.5, 1.0, or 2 micro g [centered dot] kg-1 [centered dot] min-1 dopexamine (n = 10 per group) or placebo (n = 14) prior to surgery, intraoperatively, and postoperatively. Dopexamine infusion increased systemic oxygen delivery (P <or=to 0.01). Hepatic venous oxygen saturation did not change, and pHi decreased during and after CPB in all patients (P <or=to 0.01). Postoperative increases in IL-6 were smallest in patients who received 2.0 micro g [centered dot] kg-1 [centered dot] min-1 dopexamine (P <or=to 0.02). SAA and CRP increases during the postoperative period were less pronounced with dopexamine throughout the study. Creatinine clearance was elevated in all dopexamine groups (P <or=to 0.025). This elevation was higher with lower dopexamine doses (P <or=to 0.025). We conclude that dopexamine improves creatinine clearance and reduces systemic inflammation without affecting splanchnic oxygenation. (Anesth Analg 1997;84:950-7)...