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donedeal

Low dose Dopamine

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Are any of you using Dopamine in your Non-traumatic resuscitated cardiac arrest patients, who DO have a decent BP, specifically for its perfusion effects? At 1-2mcg/kg/min Dopamine stimulates D-receptors dilating not only renal but cerebral and mesenteric vasculature. Combined with fluids to help dilute toxin buildup from a once non-perfusing patient, wouldn't dilation to these organs possibly reduce morbidity in the post arrest patient?

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Are any of you using Dopamine in your Non-traumatic resuscitated cardiac arrest patients, who DO have a decent BP, specifically for its perfusion effects? At 1-2mcg/kg/min Dopamine stimulates D-receptors dilating not only renal but cerebral and mesenteric vasculature. Combined with fluids to help dilute toxin buildup from a once non-perfusing patient, wouldn't dilation to these organs possibly reduce morbidity in the post arrest patient?

Not in post arrest, however in sepsis I have seen it given to "kik start" the kidneys in a non-hypotensive patient with an incresing lactate and decreasing Sp02.

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No, the current thinking on that is that it's ineffective and doesn't have any real benefit. (I can't recall since I haven't looked in awhile but I don't think it was detrimental, just didn't have any benefits). If they are truly normotensive, then generally (or maybe sometimes) they should be perfusing well enough until you can get more information. Different conditions will have different problems though; like sepsis where even "normotensive" patient's may be on pressors or getting transfused.

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Are any of you using Dopamine in your Non-traumatic resuscitated cardiac arrest patients, who DO have a decent BP, specifically for its perfusion effects? At 1-2mcg/kg/min Dopamine stimulates D-receptors dilating not only renal but cerebral and mesenteric vasculature. Combined with fluids to help dilute toxin buildup from a once non-perfusing patient, wouldn't dilation to these organs possibly reduce morbidity in the post arrest patient?

I think the idea of low-dose dopamine has acting via dopaminergic effects has been debunked about 10 years ago. As I recall, it was determined that at low doses we were seeing greater urine output due to an increase in MAP and renal perfusion pressure that was due to beta-adrenoceptor activation, versus any specific renovascular effects through the DA receptors.

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I have seen low dose Dopamine used in the ICU by both Cardiologist & Intensivist. They usually would start at 2.5 mcg/kg/min. It was helpful especially for people who had bradycardia, lower blood pressure & also decreased urinary output.

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