Cargando…

Dopamine Use in Intensive Care: Are We Ready to Turn it Down?

Dopamine is still frequently used as a first line vasopressor agent in hypotensive patients, when physicians are afraid of noradrenaline and believe that dopamine, with its β and α, inotrope and vasopressor effects, may be helpful. Evidence exists that it does not offer protection from renal failure...

Descripción completa

Detalles Bibliográficos
Autores principales: Marinosci, Geremia Zito, De Robertis, Edoardo, De Benedictis, Giuseppe, Piazza, Ornella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Università di Salerno 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728808/
https://www.ncbi.nlm.nih.gov/pubmed/23905068
_version_ 1782278916455530496
author Marinosci, Geremia Zito
De Robertis, Edoardo
De Benedictis, Giuseppe
Piazza, Ornella
author_facet Marinosci, Geremia Zito
De Robertis, Edoardo
De Benedictis, Giuseppe
Piazza, Ornella
author_sort Marinosci, Geremia Zito
collection PubMed
description Dopamine is still frequently used as a first line vasopressor agent in hypotensive patients, when physicians are afraid of noradrenaline and believe that dopamine, with its β and α, inotrope and vasopressor effects, may be helpful. Evidence exists that it does not offer protection from renal failure, even if at low doses (0, 3–5 mcg/Kg/min) it may exert its effects on D1 and D2 receptors resulting in natriuresis and renal vasodilation, augmentation in renal blood flow, and diuresis. The effects of dopamine on gastrointestinal system and splanchnic perfusion in critical care patients are even more controversial, since they seem to be at least partially dependent on the initial fractional splanchnic blood flow. Dopamine may exert deleterious effects on respiratory function, by impairing the ventilatory drive response to hypoxemia and hypercapnia and reducing arterial oxygen saturation through a regional ventilation/perfusion mismatching. Dopamine seems to affect the cellular mediated mechanism of the immune function directly by its action on receptors located on immune system cells and indirectly altering the hormonal response regulating immune response. In this paper, the use of low dose dopamine is discussed in the intensive care perspective.
format Online
Article
Text
id pubmed-3728808
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Università di Salerno
record_format MEDLINE/PubMed
spelling pubmed-37288082013-07-31 Dopamine Use in Intensive Care: Are We Ready to Turn it Down? Marinosci, Geremia Zito De Robertis, Edoardo De Benedictis, Giuseppe Piazza, Ornella Transl Med UniSa Review Dopamine is still frequently used as a first line vasopressor agent in hypotensive patients, when physicians are afraid of noradrenaline and believe that dopamine, with its β and α, inotrope and vasopressor effects, may be helpful. Evidence exists that it does not offer protection from renal failure, even if at low doses (0, 3–5 mcg/Kg/min) it may exert its effects on D1 and D2 receptors resulting in natriuresis and renal vasodilation, augmentation in renal blood flow, and diuresis. The effects of dopamine on gastrointestinal system and splanchnic perfusion in critical care patients are even more controversial, since they seem to be at least partially dependent on the initial fractional splanchnic blood flow. Dopamine may exert deleterious effects on respiratory function, by impairing the ventilatory drive response to hypoxemia and hypercapnia and reducing arterial oxygen saturation through a regional ventilation/perfusion mismatching. Dopamine seems to affect the cellular mediated mechanism of the immune function directly by its action on receptors located on immune system cells and indirectly altering the hormonal response regulating immune response. In this paper, the use of low dose dopamine is discussed in the intensive care perspective. Università di Salerno 2012-10-11 /pmc/articles/PMC3728808/ /pubmed/23905068 Text en http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Marinosci, Geremia Zito
De Robertis, Edoardo
De Benedictis, Giuseppe
Piazza, Ornella
Dopamine Use in Intensive Care: Are We Ready to Turn it Down?
title Dopamine Use in Intensive Care: Are We Ready to Turn it Down?
title_full Dopamine Use in Intensive Care: Are We Ready to Turn it Down?
title_fullStr Dopamine Use in Intensive Care: Are We Ready to Turn it Down?
title_full_unstemmed Dopamine Use in Intensive Care: Are We Ready to Turn it Down?
title_short Dopamine Use in Intensive Care: Are We Ready to Turn it Down?
title_sort dopamine use in intensive care: are we ready to turn it down?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728808/
https://www.ncbi.nlm.nih.gov/pubmed/23905068
work_keys_str_mv AT marinoscigeremiazito dopamineuseinintensivecarearewereadytoturnitdown
AT derobertisedoardo dopamineuseinintensivecarearewereadytoturnitdown
AT debenedictisgiuseppe dopamineuseinintensivecarearewereadytoturnitdown
AT piazzaornella dopamineuseinintensivecarearewereadytoturnitdown