Abstract
Objective: To determine whether low-dose dopamine infusion (5 pg/kg/min) during cardiopulmonary bypass selectively increases perfusion to the kidney, splanchnic organs, and brain at low (45 mm Hg) as well as high (90 mm Hg) perfusion pressures. Design: Randomized crossover trial. Setting: Animal research laboratory in a university medical center. Subjects: Ten female Yorkshire pigs (weight 29.9 ± 1.2 kg). Intervention: Anesthetized pigs were placed on normothermic cardiopulmonary bypass at a 100-mL/kg/min flow rate. After baseline measurements, the animal was subjected, in random sequence, to 15-min periods of low perfusion pressure (45 mm Hg), low perfusion pressure with dopamine (5 μg/kg/min), high perfusion pressure (90 mm Hg), and high perfusion pressure with dopamine. Regional perfusion (radioactive microspheres) was measured in tissue samples (2 to 10 g) from the renal cortex (outer two-third and inner one-third segments), stomach, duodenum, jejunum, ileum, colon, pancreas, and cerebral hemispheres. Measurements and Main Results: Systemic perfusion pressure was altered by adjusting pump flow rate (r2 = .61; p < .05). In the kidney, cortical perfusion pressure increased from 178 ± 16 mL/min/100 g at the low perfusion pressure to 399 ± 23 mL/min/100 g at the high perfusion pressure (p < .05). Perfusion pressure augmentation increased the ratio of outer/inner renal cortical blood flow from 0.9 ± 0.1 to 1.2 ± 0.1 (p < .05). At each perfusion pressure, low- dose dopamine had no beneficial effect on renal perfusion or flow distribution. Similar results were found in the splanchnic organs, where regional perfusion was altered by perfusion pressure but not by dopamine. In contrast, neither changing perfusion pressure nor adding low-dose dopamine altered blood flow to the cerebral cortex. Conclusions: These data indicate that the lower autoregulatory limits of perfusion to the kidneys and splanchnic organs differ from those limits to the brain during normothermic bypass. Selective vasodilation from low-dose dopamine was not found in renal, splanchnic, or cerebral vascular beds. Increasing the perfusion pressure by pump flow, rather than by the addition of low-dose dopamine, enhanced renal and splanchnic but not cerebral blood flows during cardiopulmonary bypass.
| Original language | English |
|---|---|
| Pages (from-to) | 1090-1098 |
| Number of pages | 9 |
| Journal | Critical Care Medicine |
| Volume | 23 |
| Issue number | 6 |
| DOIs | |
| State | Published - 1995 |
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Keywords
- blood flow
- cardiopulmonary bypass
- catecholamines
- cerebral cortex
- circulation
- critical illness
- dopamine
- perfusion pressure
- renal blood flow
- splanchnic circulation
- vascular resistance
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
Increasing organ blood flow during cardiopulmonary bypass in pigs : Comparison of dopamine and perfusion pressure. / Mackay, J. H.; Feerick, A. E.; Woodson, L. C.; Lin, C. Y.; Deyo, D. J.; Uchida, T.; Johnston, W. E.
In: Critical Care Medicine, Vol. 23, No. 6, 1995, p. 1090-1098.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Increasing organ blood flow during cardiopulmonary bypass in pigs
T2 - Comparison of dopamine and perfusion pressure
AU - Mackay, J. H.
AU - Feerick, A. E.
AU - Woodson, L. C.
AU - Lin, C. Y.
AU - Deyo, D. J.
AU - Uchida, T.
AU - Johnston, W. E.
PY - 1995
Y1 - 1995
N2 - Objective: To determine whether low-dose dopamine infusion (5 pg/kg/min) during cardiopulmonary bypass selectively increases perfusion to the kidney, splanchnic organs, and brain at low (45 mm Hg) as well as high (90 mm Hg) perfusion pressures. Design: Randomized crossover trial. Setting: Animal research laboratory in a university medical center. Subjects: Ten female Yorkshire pigs (weight 29.9 ± 1.2 kg). Intervention: Anesthetized pigs were placed on normothermic cardiopulmonary bypass at a 100-mL/kg/min flow rate. After baseline measurements, the animal was subjected, in random sequence, to 15-min periods of low perfusion pressure (45 mm Hg), low perfusion pressure with dopamine (5 μg/kg/min), high perfusion pressure (90 mm Hg), and high perfusion pressure with dopamine. Regional perfusion (radioactive microspheres) was measured in tissue samples (2 to 10 g) from the renal cortex (outer two-third and inner one-third segments), stomach, duodenum, jejunum, ileum, colon, pancreas, and cerebral hemispheres. Measurements and Main Results: Systemic perfusion pressure was altered by adjusting pump flow rate (r2 = .61; p < .05). In the kidney, cortical perfusion pressure increased from 178 ± 16 mL/min/100 g at the low perfusion pressure to 399 ± 23 mL/min/100 g at the high perfusion pressure (p < .05). Perfusion pressure augmentation increased the ratio of outer/inner renal cortical blood flow from 0.9 ± 0.1 to 1.2 ± 0.1 (p < .05). At each perfusion pressure, low- dose dopamine had no beneficial effect on renal perfusion or flow distribution. Similar results were found in the splanchnic organs, where regional perfusion was altered by perfusion pressure but not by dopamine. In contrast, neither changing perfusion pressure nor adding low-dose dopamine altered blood flow to the cerebral cortex. Conclusions: These data indicate that the lower autoregulatory limits of perfusion to the kidneys and splanchnic organs differ from those limits to the brain during normothermic bypass. Selective vasodilation from low-dose dopamine was not found in renal, splanchnic, or cerebral vascular beds. Increasing the perfusion pressure by pump flow, rather than by the addition of low-dose dopamine, enhanced renal and splanchnic but not cerebral blood flows during cardiopulmonary bypass.
AB - Objective: To determine whether low-dose dopamine infusion (5 pg/kg/min) during cardiopulmonary bypass selectively increases perfusion to the kidney, splanchnic organs, and brain at low (45 mm Hg) as well as high (90 mm Hg) perfusion pressures. Design: Randomized crossover trial. Setting: Animal research laboratory in a university medical center. Subjects: Ten female Yorkshire pigs (weight 29.9 ± 1.2 kg). Intervention: Anesthetized pigs were placed on normothermic cardiopulmonary bypass at a 100-mL/kg/min flow rate. After baseline measurements, the animal was subjected, in random sequence, to 15-min periods of low perfusion pressure (45 mm Hg), low perfusion pressure with dopamine (5 μg/kg/min), high perfusion pressure (90 mm Hg), and high perfusion pressure with dopamine. Regional perfusion (radioactive microspheres) was measured in tissue samples (2 to 10 g) from the renal cortex (outer two-third and inner one-third segments), stomach, duodenum, jejunum, ileum, colon, pancreas, and cerebral hemispheres. Measurements and Main Results: Systemic perfusion pressure was altered by adjusting pump flow rate (r2 = .61; p < .05). In the kidney, cortical perfusion pressure increased from 178 ± 16 mL/min/100 g at the low perfusion pressure to 399 ± 23 mL/min/100 g at the high perfusion pressure (p < .05). Perfusion pressure augmentation increased the ratio of outer/inner renal cortical blood flow from 0.9 ± 0.1 to 1.2 ± 0.1 (p < .05). At each perfusion pressure, low- dose dopamine had no beneficial effect on renal perfusion or flow distribution. Similar results were found in the splanchnic organs, where regional perfusion was altered by perfusion pressure but not by dopamine. In contrast, neither changing perfusion pressure nor adding low-dose dopamine altered blood flow to the cerebral cortex. Conclusions: These data indicate that the lower autoregulatory limits of perfusion to the kidneys and splanchnic organs differ from those limits to the brain during normothermic bypass. Selective vasodilation from low-dose dopamine was not found in renal, splanchnic, or cerebral vascular beds. Increasing the perfusion pressure by pump flow, rather than by the addition of low-dose dopamine, enhanced renal and splanchnic but not cerebral blood flows during cardiopulmonary bypass.
KW - blood flow
KW - cardiopulmonary bypass
KW - catecholamines
KW - cerebral cortex
KW - circulation
KW - critical illness
KW - dopamine
KW - perfusion pressure
KW - renal blood flow
KW - splanchnic circulation
KW - vascular resistance
UR - http://www.scopus.com/inward/record.url?scp=0029039605&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029039605&partnerID=8YFLogxK
U2 - 10.1097/00003246-199506000-00015
DO - 10.1097/00003246-199506000-00015
M3 - Article
VL - 23
SP - 1090
EP - 1098
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 6
ER -