Failure of dobutamine to improve liver oxygenation during resuscitation with a crystalloid solution after experimental haemorrhagic shock.

ABSTRACT

OBJECTIVE: To evaluate the effects of dobutamine on peripheral and hepatic tissue oxygen tensions during the treatment of haemorrhagic shock. DESIGN: Randomised, controlled trial. SETTING: University hospital, Finland. SUBJECTS: 12 Piglets, weight 20 kg. INTERVENTIONS: Haemorrhagic shock (40% of blood volume removed) and resuscitation with crystalloid solution. Dobutamine infused (6.5 micrograms/kg/min) during resuscitation in 6 animals and 6 served as controls. MAIN OUTCOME MEASURES: Haemodynamic and systemic oxygen transport variables. Hepatic, subcutaneous, transcutaneous, and conjunctival oxygen tensions measured continuously with polarographic electrodes. RESULTS: All values decreased significantly during bleeding. Resuscitation restored the mean arterial pressure in both groups, and cardiac output exceeded the baseline by 24% in the dobutamine group (p < 0.05 compared with control). There was no difference in oxygen delivery and consequently tissue oxygen tensions remained at the control level in the dobutamine group. CONCLUSIONS: Dobutamine infusion did not improve tissue oxygenation when used in addition to crystalloids to treat hypovolaemic shock.