Objective: To compare the effect of norepinephrine-dobutamine and that of dopamine alone on splanchnic perfusion in sheep with septic shock.
Methods: Twenty sheep with septic shock induced by lipopolysaccharides were divided into two groups. When systolic pressure was decreased to 39.75 mm Hg(1 mm Hg=0.133 kPa), basic values of hemodynamic parameters and intestinal intramucosal pH (pHi) were monitored. The animals were randomized to either receive an intravenous infusion of norepinephrine-dobutamine in combination or dopamine alone, and the dosage was titrated to obtain a mean arterial pressure (MAP)> 90.00 mm Hg with an optimal cardiac preload. Hemodynamic parameters and mucosal pHi were repeatedly measured at 1-, 2-, 3-, 4-hour after basic measurement.
Results: After norepinephrine-dobutamine or dopamine infusion, MAP, cardiac output, and oxygen delivery were increased in all animals compared to basic values in both groups (P<0.05). Compared to baseline values (4.0+/-1.8)mmol/L, lactate concentrations were decreased at 3-hour (2.3+/-1.1) mmol/L and 4-hour (2.1+/-1.1)mmol/L in the norepinephrine-dobutamine group (P<0.05). There were no differences in arterial lactate concentrations in the dopamine group, but arterial pH was decreased from 7.40+/-0.05 to 7.26+/-0.06 at 2-hour (P<0.05 ). No Change in pHi was found in the dopamine group, but in the norepinephrine-dobutamine group, compared to baseline, pHi was increased from 7.19+/-0.04 to 7.36+/-0.07 at 3-hour (P<0.05).
Conclusion: Both norepinephrine-dobutamine and dopamine could improve systemic hemodynamics in sheep with septic shock, but the effect of norepinephrine-dobutamine in combination was better than dopamine on splanchnic perfusion.