Effects of different catecholamines on the dynamics of volume expansion of crystalloid infusion

Luiz A. Vane, Donald Prough, Michael Kinsky, Chad A. Williams, James J. Grady, George Kramer

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34 Scopus citations

Abstract

Background: The authors studied the influence of α, J3, and dopaminergic catecholamines on blood volume expansion in conscious normovolemic sheep before, during, and after a bolus infusion of a crystalloid. Methods: A 0.9% NaCl bolus (24 ml/kg in 20 min) was infused in four paired experiments each: no drug, dopamine infusion (50 μg · kg -1 · min -1), isoproterenol infusion (0.1 μg · kg -1 · min -1), and phenylephrine infusion (3 μg · kg -1 · min -1). Blood volume expansion was calculated by the dilution of blood hemoglobin concentration. Results: Dopamine had little effect on peak blood volume expansion (12.7 ± 0.9 ml/kg) compared with 0.9% NaCl (13.0 ± 2.7 ml/kg); in contrast, isoproterenol augmented blood volume expansion (18.5 ± 1.8 ml/kg), and phenylephrine reduced blood volume expansion (8.9 ± 1.4 ml/kg). Two hours after the 0.9% NaCl bolus, sustained blood volume expansion was greatest in the isoproterenol protocol (12.2 ml/kg), whereas the dopamine protocol (6.8 ml/kg) remained similar to the control protocol (4.1 ml/kg), and the phenylephrine protocol had a net volume loss (-1.9 ml/kg). Some blood volume expansion differences were attributed to changes in renal function as phenylephrine infusion increased urinary output, whereas isoproterenol was associated with antidiuresis. However, dopamine caused diuresis and sustained augmentation of blood volume. Conclusion: Catecholamines can alter the intravascular volume expansion of fluid therapy. β-Receptor (isoproterenol) stimulation augmented blood volume expansion, whereas α (phenylephrine) stimulation reduced blood volume expansion. Combined dopaminergic, β, and possibly α stimulation with dopamine augmented blood volume expansion and cardiac output while inducing diuresis.

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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