Effects of Dopexamine on Creatinine Clearance, Systemic Inflammation, and Splanchnic Oxygenation in Patients Undergoing Coronary Artery Bypass Grafting

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Abstract
Ygenation, gastric mucosal pH (pHi), and mixed and hepatic venous plasma levels of endotoxin, interleukin-6 (IL-6), serum amyloid A (SAA), and C-reactive protein (CRP) in 44 patients scheduled for coronary artery bypass grafting. Patients were randomized to receive continuous infusions of 0.5, 1.0, or 2 micro g [centered dot] kg-1 [centered dot] min-1 dopexamine (n = 10 per group) or placebo (n = 14) prior to surgery, intraoperatively, and postoperatively. Dopexamine infusion increased systemic oxygen delivery (P <or=to 0.01). Hepatic venous oxygen saturation did not change, and pHi decreased during and after CPB in all patients (P <or=to 0.01). Postoperative increases in IL-6 were smallest in patients who received 2.0 micro g [centered dot] kg-1 [centered dot] min-1 dopexamine (P <or=to 0.02). SAA and CRP increases during the postoperative period were less pronounced with dopexamine throughout the study. Creatinine clearance was elevated in all dopexamine groups (P <or=to 0.025). This elevation was higher with lower dopexamine doses (P <or=to 0.025). We conclude that dopexamine improves creatinine clearance and reduces systemic inflammation without affecting splanchnic oxygenation. (Anesth Analg 1997;84:950-7)...