Details

Autor(en) / Beteiligte

• Unverferth, Donald V.
• Blanford, Marvin
• Kates, Robert E.
• Leier, Carl V.

Titel

Tolerance to dobutamine after a 72 hour continuous infusion

Ist Teil von

• The American journal of medicine, 1980-08, Vol.69 (2), p.262-266

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

1980

Quelle

Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)

Beschreibungen/Notizen

• In this study we investigated the hemodynamic effects of dobutamine during short-term (2 hour) and long-term (four day) infusions. The heart rate, blood pressure, cardiac output, pulmonary capillary wedge pressure and systolic time intervals were determined at baseline and then at 30 minute intervals up to 120 minutes after the commencement of intravenous dobutamine therapy in nine patients. The same parameters were measured in 14 patients at 2, 24, 48, 72 and 96 hours. The percent change of the hemodynamic measurements over baseline was evaluated relative to the plasma dobutamine level. There was no attenuation of hemodynamic effect in the first 2 hours of dobutamine therapy. Tolerance did develop during the long-term infusion and this was statistically significant at 72 and 96 hours in measurements of the cardiac output, systolic time intervals and heart rate. The hemodynamic response at 72 hours was 66 percent of that noted at 2 hours; the hemodynamic response at 96 hours was 57 percent of that at 2 hours. This study demonstrated that significant hemodynamic tolerance to dobutamine develops after three days of continuous infusion. We suggest that the most appropriate manner of dealing with this attenuation of effect is simply to increase the dose until the desired hemodynamic effect is attained.