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

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.