Combined hemodynamic effects of dopamine and dobutamine in cardiogenic shock.

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Abstract
In 8 mechanically ventilated patients in cardiogenic shock, the hemodynamic effects of an infusion of dopamine and dobutamine were assessed and its role in preventing the deleterious effects of administering each amine alone were evaluated. Each patient received 3 infusions in a randomly assigned order: dopamine, 15 .mu.g/kg per min; dobutamine, 15 .mu.g/kg per min; and a combination of dopamine, 7.5 .mu.g/kg per min and dobutamine, 7.5 .mu.g/kg per min. Stroke volme index increased similarly with the 3 infusions, but dopamine alone increased O2 consumption (P < 0.05 vs. dobutamine alone and dopamine-dobutamine combined). The dopamine-dobutamine combination increased mean arterial pressure (P < 0.05 vs. dobutamine), maintained pulmonary capillary wedge pressure within normal limits (P < 0.05 vs. dopamine) and prevented the worsening of hypoxemia induced by dopamine (P < 0.05). The dopamine-dobutamine combination appears to be useful in the management of mechanically ventilated patients in cardiogenic shock.