The effect of dopexamine on organ dysfunction in the critically ill patient

Abstract

It has been postulated that an increase in gut hyperpermeability may be an important factor in the development of multiple organ failure and mortality in the critically ill.1 Dopexamine increases splanchnic blood flow and has been shown to maintain gastrointestinal integrity by reducing hyperpermeability in certain groups of critically ill patients.2 We have assessed the effect of a prolonged infusion of dopexamine in preventing multiple organ failure in a randomised controlled study. Organ dysfunction was quantified by the SOFA (sequential organ failure assessment) score.3 After initial resuscitation, critically ill patients predicted to require organ support in intensive care for more than 4 days were randomly allocated to receive dopexamine at 2 μg kg−1 min−1 as an infusion for 7 days or control. SOFA scores were performed daily throughout the study period using the most abnormal value for each parameter in each 24-h period. One hundred patients were recruited to the study, of whom 52 received dopexamine. There was no significant difference in ages (mean (SD): dopexamine 62 yr (15.6); control 58 yr (18)), APACHE scores (dopexamine 20.9 (6.6); control 20.2 (5.9)), length of stay (dopexamine 9.7 days (1.08); control 12 days (0.94)), or survival to hospital discharge (dopexamine 23/52; control 22/48). We tested for a difference in SOFA scores at day 4 and day 7 compared to day 1 (Table 2). We conclude that in this group of critically ill patients a prolonged infusion of dopexamine did not have any beneficial effects in terms of mortality, length of ICU stay or organ failure score.