Wednesday January 11, 2006
Dopamine-S and Dopamine-R patients ?
Interesting article published in October 2005 issue of Critical Care Medicine which concluded that "Dopamine sensitivity is associated with decreased mortality rate".
In 110 patients after failure of vascular loading, Dopamine infusion started with 5 μg/kg/min and infusion rate was increased by 5 μg/kg/min every 10 mins up to a maximum dose of 20 μg/kg/min to target mean arterial pressure ≥ 70 mm Hg. (So total time needed to reach the highest dose of 20 μg/kg/min was 30 mins). Dopamine resistance was defined by a mean arterial pressure <70.>In the Dopa-S group, the 28-day mortality rate was 16% (seven of 44 patients) compared with 78% (52 of 66 patients) in the Dopa-R group (p = .0006). The capacity of dopamine resistance to predict death was associated with a sensitivity of 84% and a specificity of 74%.
Do we need to qualify our patients as Dopamin-S or Dopamin-R to execute different management strategy?
References: click to get article/abstract
1. Cardiovascular response to dopamine and early prediction of outcome in septic shock: A prospective multiple-center study. - Critical Care Medicine. 33(10):2172-2177, October 2005