Increasing organ blood flow during cardiopulmonary bypass in pigs: Comparison of dopamine and perfusion pressure

J. H. Mackay, A. E. Feerick, L. C. Woodson, C. Y. Lin, D. J. Deyo, T. Uchida, W. E. Johnston

    Research output: Contribution to journalArticle

    44 Citations (Scopus)

    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 languageEnglish
    Pages (from-to)1090-1098
    Number of pages9
    JournalCritical Care Medicine
    Volume23
    Issue number6
    DOIs
    StatePublished - 1995

    Fingerprint

    Cardiopulmonary Bypass
    Dopamine
    Swine
    Perfusion
    Pressure
    Viscera
    Kidney
    Cerebrovascular Circulation
    Infusion Pumps
    Renal Circulation
    Brain
    Cerebrum
    Jejunum
    Microspheres
    Ileum
    Duodenum
    Vasodilation
    Cerebral Cortex
    Cross-Over Studies

    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

    Mackay, J. H., Feerick, A. E., Woodson, L. C., Lin, C. Y., Deyo, D. J., Uchida, T., & Johnston, W. E. (1995). Increasing organ blood flow during cardiopulmonary bypass in pigs: Comparison of dopamine and perfusion pressure. Critical Care Medicine, 23(6), 1090-1098. https://doi.org/10.1097/00003246-199506000-00015

    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 journalArticle

    Mackay, JH, Feerick, AE, Woodson, LC, Lin, CY, Deyo, DJ, Uchida, T & Johnston, WE 1995, 'Increasing organ blood flow during cardiopulmonary bypass in pigs: Comparison of dopamine and perfusion pressure', Critical Care Medicine, vol. 23, no. 6, pp. 1090-1098. https://doi.org/10.1097/00003246-199506000-00015
    Mackay, J. H. ; Feerick, A. E. ; Woodson, L. C. ; Lin, C. Y. ; Deyo, D. J. ; Uchida, T. ; Johnston, W. E. / Increasing organ blood flow during cardiopulmonary bypass in pigs : Comparison of dopamine and perfusion pressure. In: Critical Care Medicine. 1995 ; Vol. 23, No. 6. pp. 1090-1098.
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    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.

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    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.

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    KW - renal blood flow

    KW - splanchnic circulation

    KW - vascular resistance

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