Vol. 284, Issue 2, H668-H675, February 2003
Dopamine-1 receptor stimulation impairs intestinal oxygen
utilization during critical hypoperfusion
Jorge A.
Guzman,
Ariosto E.
Rosado, and
James A.
Kruse
Division of Pulmonary, Critical Care, and Sleep
Medicine, Wayne State University School of Medicine, Detroit,
Michigan 48201
Effects of a dopamine-1 (DA-1) receptor
agonist on systemic and intestinal oxygen delivery
(
O2)-uptake relationships were studied
in anesthetized dogs during sequential hemorrhage. Control (group
1) and experimental animals (group 2) were treated
similarly except for the addition of fenoldopam (1.0 µg · kg
1 · min
1)
in group 2. Both groups had comparable systemic critical
O2 (
O2crit), but animals in group
2 had a higher gut
O2crit
(1.12 ± 1.13 vs. 0.80 ± 0.09 ml · kg
1 · min
1,
P < 0.05). At the mucosal level, a clear biphasic
delivery-uptake relationship was not observed in group 1;
thus oxygen consumption by the mucosa may be supply dependent under
physiological conditions. Group 2 demonstrated higher peak
mucosal blood flow and lack of supply dependency at higher mucosal
O2 levels. Fenoldopam resulted in a more
conspicuous biphasic relationship at the mucosa and a rightward shift
of overall splanchnic
O2crit despite
increased splanchnic blood flow. These findings suggest that DA-1
receptor stimulation results in increased gut perfusion heterogeneity
and maldistribution of perfusion, resulting in increased susceptibility to ischemia.
oxygen supply dependency; splanchnic ischemia; vasodilators