Не надо использовать допамин при ОПН

[Alexey Dyachkov]

Из книги P. Marino, The ICU book, 3rd edition

Don't Use Low-Dose Dopamine

Despite more than thirty years of use as a renal vasodilator, low-dose dopamine (2 μg/kg/min) has shown no evidence of benefit in patients with acute oliguric renal failure (10,11). In fact, low-dose dopamine can have deleterious effects on hemodynamics (decreased splanchnic blood flow), immune function (inhibition of T-cell lymphocyte function) and endocrine function (inhibition of thyroid-stimulating hormone release from the pituitary) (11). For these reasons, the use of low-dose dopamine in patients with acute oliguria is (borrowing the title from reference 11) bad medicine.

10. Kellum JA, Decker JM. Use of dopamine in acute renal failure: a meta-analysis. Crit Care Med 2001;29:1526–1531.

11. Holmes CL, Walley KR. Bad medicine: low-dose dopamine in the ICU. Chest 2003;123:1266–1275.

[Alexey Dyachkov]

Немного картинок на тему

[Евгений Хоменко]

Знаешь Леша, что я тут подумал...пришла на ум аналогия с салом..

Может быть Допамин не просто не эффективен, может быть он просто вреден ...

А сало - оно тоже вредное , но многие фаталисты так его любят , что отказаться не могут, даже если знают про вред, а ведь большинство - просто не знает и хавает даже не переживая ни о чем...

ВОТ ТАКИЕ БРАТ ДЕЛА в РАШЕ,

[minin sergey]

Prophylactic administration of “low-dose” or
“renal dose” dopamine (1–3μg/kg/min) increases
urine output but has not been demonstrated to
improve or prevent perioperative renal dysfunction
There is concern that prophylactic dopamine
administration may not be benign given the fact
that it is associated with release of markers such
as β2-microglobulin that are indicative of subclinical
renal tubular injury. In addition, prophylactic
dopamine administration may compromise
splanchnic mucosal perfusion and predispose to
development of postoperative atrial fibrillation

Anesthesia for Cardiac Surgery
James A. DiNardo, MD
Special Considerations 433