Effect of dopexamine on hepatic metabolic activity in patients with septic shock

Shock. 2001 Jun;15(6):427-31. doi: 10.1097/00024382-200115060-00003.

Abstract

Hepato-splanchnic metabolic activity is seen to be related to regional blood flow and oxygen/substrate availability in patients with sepsis. Catecholamines, which may modulate metabolic activity perse, are common to stabilize hemodynamics. We studied the effect of a dopexamine-induced increase in splanchnic blood flow (Qspl) on regional metabolic rate in 10 patients with septic shock requiring norepinephrine to maintain mean arterial pressure (>60 mmHg). Splanchnic blood flow was determined using the indocyanine-green method with hepatic venous sampling. We determined the hepato-splanchnic lactate, pyruvate, alanine, and glutamine turnover and the lactate/pyruvate and ketone body ratio as well as the endogenous glucose production (EGP) using the stable isotope approach. Qspl increased from 0.86 (0.79-1.15) to 0.96 (0.92-1.33) L/min/m2, not influencing any parameter of metabolic activity. We speculate that this finding is due to altered beta-adrenoreceptor-mediated thermogenic effects due to the interplay of different beta-sympathomimetics at the receptor site.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alanine / metabolism
  • Blood Pressure / physiology
  • Dopamine / analogs & derivatives
  • Dopamine / pharmacology*
  • Dopamine / therapeutic use*
  • Female
  • Glucose / metabolism
  • Glutamic Acid / metabolism
  • Hemodynamics / drug effects
  • Hemodynamics / physiology
  • Humans
  • Ketone Bodies / metabolism
  • Lactates / metabolism
  • Liver / blood supply
  • Liver / drug effects
  • Liver / metabolism*
  • Male
  • Middle Aged
  • Norepinephrine / therapeutic use
  • Oxygen / blood
  • Oxygen Consumption / drug effects
  • Pyruvates / metabolism
  • Regional Blood Flow / drug effects
  • Shock, Septic / drug therapy*
  • Shock, Septic / metabolism*
  • Shock, Septic / physiopathology
  • Splanchnic Circulation / drug effects
  • Vasodilator Agents / pharmacology*
  • Vasodilator Agents / therapeutic use

Substances

  • Ketone Bodies
  • Lactates
  • Pyruvates
  • Vasodilator Agents
  • dopexamine
  • Glutamic Acid
  • Glucose
  • Alanine
  • Oxygen
  • Dopamine
  • Norepinephrine