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PubMed1993

Perioperative platelet reactivity and the effects of clonidine.

BACKGROUND: Increased postoperative platelet reactivity may contribute to arterial thrombotic complications following surgery. alpha 2 Agonists, which are being used increasingly to blunt the stress response of surgery, increase platelet aggregation in vitro. We compared perioperative changes in platelet reactivity in 21 patients receiving either clonidine or placebo. METHODS: Patients undergoing major abdominal surgery were randomized to receive oral and transdermal clonidine (n = 11) or placebo (n = 10). All patients received similar perioperative management, including preoperative sedation, general anesthesia without neuraxial opioids, or local anesthetics and postoperative patient-controlled intravenous morphine. Blood was obtained for measurement of clonidine level, fibrinogen concentration, platelet count, and platelet reactivity (impedance aggregometry and dense granule release) before induction and 24, 48, and 72 h postoperatively. RESULTS: Thirteen of the 21 patients had biopsy-proven cancer at surgery, 5 of 11 received clonidine and 8 of 10 received placebo (NS). Clonidine levels were therapeutic (1-2 ng/ml) throughout the study period. Clonidine administration had no effect on platelet count or platelet reactivity. Therefore, the groups were combined for further analysis. In this group (n = 21), compared to preoperative values, fibrinogen levels rose maximally (36%) at 72 h postoperatively and platelet counts decreased 22% at 48 h. Platelet reactivity (aggregation and degranulation) to collagen, adenosine diphosphate, arachidonic acid, and ristocetin, increased at 24, 48, and 72 h postoperatively. Thrombin-induced (supramaximal stimulus) dense granule release did not change from preoperative values. CONCLUSIONS: These data indicate that major abdominal surgery causes increased platelet reactivity postoperatively but does not effect maximal degranulation. This increased platelet reactivity occurs within 48 h of surgery, coinciding with the peak incidence of postoperative arterial thrombotic complications. Clonidine administration has no effect on surgically induced changes in platelet reactivity. In this surgical patient population, the use of clonidine should not increase the risk of platelet-induced perioperative arterial thrombosis.

Abdomen↗
PubMed1995

[Risk in major hepatectomy. A consecutive series of 113 extensive hepatectomies].

Up to now, liver resections have been the initial treatment of almost all cancers and benign tumors limited to a liver lobe. This retrospective review assesses the results of a consecutive series of 113 major elective hepatic resections during a ten-year period. Major hepatectomy was defined by the resection of at least 3 Couinaud segments. Mean age was 52 years (20 to 79 years). There were 62 women and 51 men. 35 resections were performed for colorectal metastases, 22 for a benign tumor, 20 for non-colorectal metastases, 11 for hydatid disease, 10 for hepatocarcinoma, 7 for cholangiocarcinoma and 8 for other indications. The resections performed were 86 right hepatectomies with 18 extended right hepatectomies, 24 left hepatectomies with 4 extended left hepatectomies and 3 trisegmentectomies. Total vascular exclusion was used in 22 patients (19%). Mortality rate was zero. Significant morbidity was encountered in 24 patients (21%). These results suggest that the mortality rate may be independent of the extent of liver resection, provided that hepatic function is normal and preoperative selection adequate. With improving surgical management and techniques, and the use of intra-operative sonography, extensive liver surgery can now be performed with a very low mortality rate.

Adult↗
PubMed1984

Insulin-dependent diabetes during the peri-operative period. An assessment of continuous glucose-insulin-potassium infusion, and traditional treatment.

Twenty seven insulin-dependent diabetics, and six non-diabetic subjects undergoing elective surgery have been studied. Twelve diabetics received continuous glucose-insulin-potassium (GIK) infusion for at least 4 hours after surgery terminated. Six diabetic patients having morning surgery received a proportion of their morning insulin dose with intravenous glucose (25 g) before surgery and the remaining five operated on in the afternoon received their morning insulin with breakfast. Non-GIK groups were combined and compared with GIK. Postoperative diabetic treatment was the same in both groups. Plasma glucose changes were studied in all patients and other metabolites whenever possible. Mean pre-operative glucose, non-esterfied fatty acid, and 3-hydroxybutyrate concentrations were similar in GIK and non-GIK groups. Four hours postoperatively plasma glucose, and 3-hydroxybutyrate values were lower in the GIK group than in the non GIK group (p less than 0.05) as were mean plasma non-esterfied fatty acid levels. Plasma glucose concentration was also lower in GIK subjects at 72 hours postoperatively (p less than 0.01). At other times measured metabolic variables were similar in both GIK and non GIK groups.

Blood Glucose↗
PubMed1997

Interindividual variations in cytokine levels following cardiopulmonary bypass.

Cardiopulmonary bypass (CPB) is associated with an inflammatory response, mainly caused by the trauma of surgery, contact of blood with the artificial surface of the circuit, and reperfusion injury, resulting in increased capillary permeability, respiratory distress, low cardiac output, and multiorgan failure. The inflammatory reaction includes an activation of the humoral and cellular immune system with enhanced release of cytokines. The present study focused on the effect of CPB on the time course of pro- and anti-inflammatory cytokines. In 20 patients undergoing coronary artery bypass grafting, the plasma concentration of interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-2, IL-4, IL-6, IL-8, and IL-10 was investigated pre-, intra-, and postoperatively by enzyme-linked immunosorbent assay technique. With the exception of IFN-gamma, all the other cytokines could be detected in the patients plasma. However, neither TNF-alpha nor IL-1 beta and IL-2 revealed significant changes in concentration during the investigated time period. In contrast, IL-6 and IL-8 levels peaked early postoperatively, reaching median concentrations of 430 pg/ml (221 pg per ml/558 pg per ml; lower/upper quartiles, respectively) and approximately 12 pg/ml (0/17 pg/ml; lower/upper quartiles, respectively). IL-4 and IL-10, respectively, revealed maximal concentrations of approximately 2 pg/ml (0/39 pg/ml; lower/upper quartiles, respectively) and 208 pg/ml (76 pg per ml/380 pg per ml; lower/upper quartiles, respectively) immediately after protamine administration, preceding the maximal concentration of IL-6. The degree of the observed modulation of cytokine patterns during and after CPB seemed to be patient-dependent, since large interindividual variations in cytokine levels were observed, not only preoperatively, but especially during and following CPB. However, IL-6 and IL-10 showed the least interindividual variations, suggesting that these cytokines may give reliable information regarding modulation of the immune response following CPB and its consequences for the patient's outcome.

Adult↗
PubMed1991

Different modulation of the perioperative stress hormone response under neurolept-anaesthesia or enflurane for cholecystectomy.

Two groups of 13 patients, randomly allocated to receive either enflurane or neurolept anaesthesia for cholecystectomy, were compared in their cardiovascular and neuroendocrine response to surgery and in the postoperative period. There were no significant differences in blood pressure or heart rate. Catecholamine values were higher under neurolept anaesthesia towards the end of surgery and postoperatively. Median values for adrenaline during suture of peritoneum were 342 pg/ml and 88 pg/ml, respectively, P less than 0.05. In contrast, ACTH and cortisol rose to higher levels in enflurane treated patients. At the end of surgery median ACTH values were 75 pg/ml in NLA patients and 322 pg/ml in enflurane patients (P less than 0.01). Vasopressin increments during surgery were similar under both regimens, while prolactin was higher following induction of neurolept anaesthesia. It is discussed whether the differences in stress hormone secretion patterns under either form of anaesthesia reflect different stress protective properties or direct pharmacological effects of certain anaesthetics. We conclude that the hormonal stress response to surgery is critically dependent on the type of anaesthesia and may be discordant in different hormonal systems.

Adrenocorticotropic Hormone↗
PubMed1992

Microbiology of postoperative wound infection: a prospective study of 1770 wounds.

A prospective study of postoperative wound infection was carried out over a 12-month period. Intra-operative swabs from the patients' anterior nares, the opened viscus and parietes were cultured using standard bacteriological techniques. Of the 1770 wounds studied, 167 (9.4%) became infected. Wound infection rates, according to clinical wound types, were clean 5.9%, clean-contaminated 10.7%, contaminated 24.3% and dirty 52.9%. The figures according to microbiological wound types were clean 4.7%, and potentially, lightly and heavily contaminated 15.3%, 22.1% and 30.2% respectively. The commonest causative organisms were Staphylococcus aureus 23.7%, Escherichia coli 16.9%, Staphylococcus epidermidis 13.5% and Pseudomonas aeruginosa 13.0%. When isolated intra-operatively, Enterobacter spp., Proteus spp., Klebsiella spp. and P. aeruginosa appeared to have a high probability of causing postoperative wound infection, but the intra-operative isolation of Bacteroides sp. was a poor predictor of subsequent wound infection.

Adolescent↗
PubMed1987

[Abdominal aortic aneurysm--is a conservative attitude still justified? Experiences with 56 emergency and 128 elective surgical patients from the anesthesiological and vascular surgery viewpoints].

A retrospective analysis was undertaken of a consecutive series of 184 patients operated on between 1.1. 1984 and 31. 12. 1985 for aneurysm of the abdominal aorta. Rupture of the aneurysm had occurred in 56 patients (aged 70 +/- 9 yrs), 47 (aged 66 +/- 9 yrs) had symptoms of an aneurysm, and 81 (aged 66 +/- 5 yrs) were operated on electively. The highest peri-operative hospital mortality rate, of 35.9%, was among the group with rupture (compared with 8.5% for the symptomatic group and 1.2% for the elective one). The period of intensive care in surviving patients was highest in the rupture group, at 8 +/- 17 days, compared with 3 +/- 2 in the symptomatic and 3 +/- 3 days in the elective group. Duration of postoperative hospital stay was 20 +/- 13, 15 +/- 7 and 13 +/- 6 days, respectively, in the three groups. Half of the patients also had arterial obstructive disease, arterial hypertension and/or coronary heart disease (25% had had an infarct according to the history, 8% more than one). A third of the patients received or should have received treatment for lung or respiratory tract disease, heart failure and/or cardiac arrhythmias. The thirty-fold increase in mortality rate for an emergency operation over that for elective surgery, together with the higher costs and longer hospital treatment, as well as the reduced probability of survival with conservative treatment speak for an aggressive approach towards elective surgery after optimal pre-operative treatment.

Adult↗
PubMed1997

7.5% hypertonic saline versus 20% mannitol during elective neurosurgical supratentorial procedures.

This prospective randomized clinical study was designed to compare the effects of equal volumes of 7.5% hypertonic saline solution (HS) or 20% mannitol (M) on brain bulk and lumbar cerebrospinal fluid pressure (CSFP) during elective neurosurgical procedures (aneurysm, arteriovenous malformation, or tumor). After informed consent, 50 American Society of Anesthesiologists physical Status I (ASA I) patients were randomly assigned to M (n = 25) or HS (n = 25) groups. Anesthesia protocol was identical for both, and variables monitored included mean arterial blood pressure (MAP), heart rate (HR), central venous pressure (CVP), CSF pressure (CSFP), arterial blood gases (PaCO2 30-35 mm Hg), serum sodium, potassium, and osmolality, and diuresis. The study period started before hypertonic solution administration (T0) and ended at the opening of the dura mater or 60 min after T0. Data were assessed with repeated measures analysis of variance and Student t test with Bonferroni correction (p < or = 0.05). MAP and CVP were the same in the two groups. After treatment, osmolality increased, and the increase at T15 was higher in HS-treated patients [316.6 +/- 9.3 vs. 304.0 +/- 12.0 (SD) mOsmol/kg; p < 0.001]. Sodium decreased after M and increased after HS. During the study, brain bulk was always considered satisfactory. CSFP was not different between M and HS groups and significantly decreased overtime (p = 0.0056) with no difference between treatments. The results of the present study demonstrate that hypertonic saline is as effective as mannitol in reducing the brain bulk and the CSFP during elective neurosurgical procedures under general anesthesia.

Blood Pressure↗
PubMed1994

Pharmacodynamics of chimeric glycoprotein IIb/IIIa integrin antiplatelet antibody Fab 7E3 in high-risk coronary angioplasty.

BACKGROUND: Thrombosis has been implicated as central to the clinical complications of coronary angioplasty (PTCA). Chimeric monoclonal 7E3 Fab (c7E3 Fab) is the first of a new class of antiplatelet drugs directed at the platelet glycoprotein IIb/IIIa integrin. This study was performed to determine the pharmacodynamics of c7E3 Fab administration during PTCA and to gain an initial clinical experience with this novel agent. METHODS AND RESULTS: The study was a multicenter, open-label, dose-escalation study conducted in two stages. Enrollment included 56 patients scheduled for elective PTCA who were estimated to be at moderate to high risk of sustaining ischemic complications. All patients were given aspirin and heparin. The study drug was given at least 10 minutes before PTCA. In stage 1, increasing bolus doses of c7E3 Fab were given to 15 patients; a bolus dose of 0.25 mg/kg was found to result in blockade of > 80% of the receptors and reduce platelet aggregation to < 20% compared with baseline, establishing this dose as that necessary to sufficiently suppress platelet activity. In stage 2, additional c7E3 Fab was administered by continuous infusion to 32 patients for progressively longer periods of time (up to 24 hours) to confirm that platelet inhibition could be maintained with prolonged drug infusion. Also, 9 patients otherwise meeting entry criteria were given placebo. There were no thrombotic events among patients receiving c7E3 Fab. Overall procedural and clinical success and complication rates as well as rates of bleeding were statistically similar among groups. However, minor bleeding was more frequent with administration of the active drug. CONCLUSIONS: The novel antiplatelet agent c7E3 Fab can be administered during PTCA in combination with aspirin and heparin. Suppression of platelet activity is dose dependent and can be maintained for up to 24 hours. Further evaluation will be required to determine the extent of improvement in ischemic complication and restenosis rates and to provide additional insight into the safety profile of this potent monoclonal platelet antibody.

Abciximab↗
PubMed1993

Rheumatoid arthritis as a cause of cardiac compression. Favourable long-term outcome of pericardiectomy.

In order to clarify the significance of rheumatoid arthritis (RA) as a cause of cardiac compression, we scrutinized pericardiectomy files of 47 patients over a ten-year period at two university hospitals in Finland. Five patients with RA were found. All the patients with RA were men with seropositive disease and subcutaneous rheumatoid nodules. Two of the patients had pulmonary fibrosis, one had cutaneous vasculitis and three had had rheumatoid pleurisy. There was a mean delay of 10 months from the first cardiac symptom to the diagnosis of cardiac compression, the most common misdiagnosis being primarily a liver disease. On the basis of clinical and operative data, four out of the five patients had constrictive pericarditis and one had an effusive-constrictive form of the disease. The histopathological findings in all cases were consistent with chronic fibrosing pericarditis. A follow-up of seven to seventeen years of four patients has not revealed any signs of recurrent pericardial disease. Our results demonstrate that RA is an important aetiological factor for cardiac compression. The long-term outcome of this manifestation seems to be good after pericardiectomy.

Adult↗
PubMed1989

Effect of peroperative normothermia on postoperative protein metabolism in elderly patients undergoing hip arthroplasty.

We have examined in elderly patients the effect of maintenance of normothermia during hip surgery on postoperative protein metabolism. In one group of six patients (warmed group) heat loss was minimized during surgery and in the recovery period by warming fresh gases, i.v. fluids and wrapping the exposed parts of the body with a warming blanket. In a second group of six patients (cold group), routine care was provided. General anaesthesia consisted of thiopentone, tubocurarine and halothane in both groups. Urinary excretion of urea nitrogen and 3-methylhistidine (3-MeH) after surgery was significantly lower in the warmed group compared with the cold group (P less than 0.05). There was little effect of normothermia on amino acid concentrations in plasma after surgery. Muscle glutamine concentration 4 days after surgery decreased by 50% in the cold group and 18% in the warmed group. Total body potassium (TBK), measured as an index of body cell mass, decreased significantly after surgery in both groups. However, 7 days after surgery the reduction in TBK in the cold group remained significantly lower than that of the warmed group (P less than 0.05). Maintenance of normothermia during hip surgery appeared to attenuate, but not eliminate, protein breakdown and nitrogen loss after surgery.

Aged↗
PubMed2004

Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: impact of experience on the results in 182 cases.

BACKGROUND: There has been discussion about the value of laparoscopic pyloromyotomy (LP) for the treatment of hypertrophic pyloric stenosis (HPS). In their initial small series, the authors reported a relatively high complication rate. The current study was undertaken to investigate the influence of experience with LP on operative time, complication rate, and postoperative hospital stay for a large number of patients. METHODS: Between October 1993 and March 2002, 182 children underwent LP for HPS. These procedures involved 11 surgeons, 4 consultants, and 7 trainees. The end points of the study were operative time, complications, and postoperative hospital stay. The outcome of 146 LPs performed after July 1996 was compared with the outcome of 36 LPs performed before that period. RESULTS: There was no significant difference in the mean operative time between the two series, but the operative time per surgeon dropped with experience. Mucosal perforation was experienced by 8.3% of the patients in the initial series, as compared with 0.7% in the later series. Insufficient pyloromyotomy occurred in 8.3% of the initial series, as compared with 2.7% of the later series. Other minor complications such as wound infection were infrequent and not influenced by further experience. Major wound-related problems did not occur. The LP procedure was easily learned by novices. After about 15 pyloromyotomies, the operative time was approximately 25 min. The length of postoperative hospital stay also dropped with increasing experience. CONCLUSIONS: The value of LP for the treatment of HPS has been proved. The LP procedure is as quick as the open procedure, has a low morbidity, and is devoid of major wound-related problems. Moreover, the procedure seems to be well teachable.

Clinical Competence↗
PubMed2007

A new method of biliary sampling for cytopathological examination during endoscopic retrograde cholangiography.

OBJECTIVES: Biliary brushing during endoscopic retrograde cholangiography (ERC) may allow the diagnosis of cancer, but this technique is limited by a low (18-57%) sensitivity. We compared the cellular and diagnostic yields of a new sampling method (using stricture dilation and a grasping basket) with those of brushing. METHODS: Sixty consecutive patients with a suspected malignant obstruction of the common bile duct were included in a consecutive, nonrandomized order. They underwent sampling during ERC using the new method (study patients, N = 30) or a brush (control patients, N = 30). A final diagnosis of cancer was made in 22/30 (73%) study patients and 21/30 (70%) control patients. At the end of the study period, all smears were interpreted at cytopathological examination in a blind and random fashion for cellularity (insufficient, low, moderate, or high) and diagnosis (normal, atypical considered reactive, highly atypical suspicious for cancer, or malignant). "Highly atypical" and "malignant" diagnoses were considered as indicative of cancer. RESULTS: Compared with biliary brushing, the new method provided a high cellular yield in more cases (19/30 vs 10/30, P= 0.020), a higher sensitivity for the detection of cancer (19/22 [86%] vs 11/21 [52%], P= 0.015), and a higher diagnostic accuracy (27/30 [90%] vs 20/30 [67%], P= 0.028). Specificity for the detection of cancer was 100%. The 30-d complication rate observed with the new method was 3%. CONCLUSIONS: Significantly higher cellular and diagnostic yields can be obtained at ERC in patients with suspected malignant biliary stricture by combining stricture dilation and a grasping basket compared with brushing.

Aged↗
PubMed2006

Frozen section diagnosis of pancreatic malignancy: a sensitive diagnostic technique.

BACKGROUND: Patients with potentially resectable pancreatic masses, without evidence of metastatic disease, require surgical exploration. We assessed the reliability of frozen section diagnosis of pancreatic malignancy. METHODS: We analysed data from 120 patients who underwent pancreatic exploration, including frozen section assessment, over a period of 41 months. RESULTS: A total of 310 pancreatic biopsies were sent for frozen section analysis. The frozen section result concurred with the final histological diagnosis in 98.1% of biopsies. The false-negative rate was 1.9%, with the correct diagnosis being established on subsequent frozen section in half of these cases. Only 3 patients were not correctly diagnosed intra-operatively by frozen section. The majority of tumours identified were pancreatic ductal adenocarcinomas, but endocrine tumours and lymphoma were also detected. 15 (12.5%) patients required more than one set of biopsies in order to establish a diagnosis of malignancy. 19 (15.8%) patients had malignant disease outside the pancreas, making their tumours unsuitable for curative resection. CONCLUSIONS: Frozen section diagnosis is very reliable in the assessment of pancreatic masses and accurately differentiates between benign and malignant disease. More than one biopsy is needed to make a diagnosis, and if clinically suspicious, successive sets of biopsies may be required.

Adult↗
PubMed2004

Gilliatt-Sumner hand revisited: a 25-year experience.

OBJECTIVE: Thirty-three patients with true neurogenic thoracic outlet syndrome, or Gilliatt-Sumner hand, underwent surgical treatment at Louisiana State University during a 25-year period. This study retrospectively evaluated the outcome referable to pain and motor function in these patients. METHODS: All patients had the typical Gilliatt-Sumner hand, secondary to compression of C8, T1, and/or lower trunk. Nineteen patients underwent an anterior supraclavicular approach, and 15 patients underwent a posterior subscapular approach to the brachial plexus. Nerve action potential recordings showed plexus involvement close to the spine, at the level of the junction of the spinal nerves to the lower trunk. RESULTS: Pain, present in 22 patients, improved in 21. Mild motor deficit improved in 12 of 14 patients. Severe motor deficit improved partially in 14 of 20 patients. CONCLUSION: The diagnosis of true neurogenic thoracic outlet syndrome provides a clear operative indication. Surgical decompression needs to involve the medial portion of the plexus, and especially the spinal nerves. An anterior supraclavicular approach is preferred in most cases. If there is a large cervical rib or there has been a prior anterior operation, then a posterior subscapular approach is indicated.

Action Potentials↗
PubMed1991

[Resuscitation during renal transplantation in children].

Over a 4 yr-period, 60 children (aged 10 months to 17 yr) received 66 kidney transplants with the same surgical intensive care program, the fist 48 hr-period of which has been analysed in this study. Thirty percent of recipients were transplanted without previous dialysis and in 8%, body weight was below 10 kg at the time of surgery. The duration of anesthesia was 4.4 +/- 1.0 h and 32% received locoregional anesthesia. The mean duration for cold ischemia was 14.7 +/- 11.7 h and 26 +/- 7 min for warm ischemia; diuresis began during the operation in 79% of the patients. Routine vascular filling consisted of standard isotonic solute (11 +/- 4 ml/kg/h) associated with mannitol infusion; 59% of recipients required 20% human serum albumin and 42% blood transfusion. Post-operative diuresis was 7.4 +/- 6.0 ml/kg/h during the first 24 h, and sometimes resulted in hypovolemic episodes; 9% of the patients had primary non-functioning kidneys (4 transient acute tubular necrosis; 2 vascular thrombosis) and 4% required dialysis; the 1-yr survival rate was 82% for the grafts and 98% of the patients.

Adolescent↗
PubMed1996

Depression of excitatory effects of propofol induction by fentanyl.

Propofol is an intravenous anesthetic drug commonly used in outpatient anesthesia for its rapid and smooth onset of action, short recovery period and its minimal perioperative side effects. However, propofol like other intravenous anesthetic drugs can produce excitatory signs during induction without signs of epilepsy on EEG. We studied 64 patients scheduled for various outpatient procedures. The patients were allocated to 2 groups: Group A (n = 32) received on induction xylocaine 1 mg.Kg-1 followed by propofol 2 mg.Kg-1 over 20 seconds, Group B (n = 32) received xylocaine 1 mg.Kg-1 and fentanyl 1.5 ug.Kg-1 followed by propofol 2 mg.Kg-1 over 20 seconds. The incidence of excitatory movements (cough, hiccup, hypertonus, twitching or tremors) was in group A (13) significantly higher than that in group B (1), there was no significant difference between the two groups in the time of stay in the post anesthesia care unit. Fentanyl 1.5 ug.Kg-1 used in outpatient anesthesia with propofol 2 mg.Kg-1 provides cardio-vascular stability, deepens the anesthesia level, decrease the awareness and decrease the excitatory effects or propofol.

Adjuvants, Anesthesia↗
PubMed1999

Effects of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery.

OBJECTIVE: To study the influence of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery. DESIGN: Prospective, randomized, placebo-controlled study. SETTING: University hospital. PATIENTS: Eighteen adult patients undergoing elective major abdominal surgery. INTERVENTIONS: The patients received either dopexamine at 1 microg/kg/min (group A, n = 9) or 0.90% saline as control (group B, n = 9). MEASUREMENTS AND RESULTS: To assess the splanchnic oxygenation, intestinal tissue PO2 (PtissO2) and gastric intramucosal Pco2 (PmucCO2) were measured, and the PCO2 gap (PmucCO2 - PaCO2) was calculated at baseline (T1) and after an infusion period of 60 mins (T2). There was no difference between the groups in the global oxygen transport parameters. Low-dose dopexamine increases PtissO2 on the serosal side of the small bowel (deltaPtissO2, 17+/-24 mm Hg in group A vs. -5+/-10 in group B). The changes in PtissO2 at the serosal side of the colon after dopexamine demonstrated a nonsignificant increase (deltaPtissO2, 7+/-11 mm Hg in group A vs. -11+/-23 mm Hg in group B). In both groups, the Pco2 gap (group A, 6+/-7 mm Hg [T1] and 5+/-6 mm Hg [T2], vs. group B, 9+/-10 mm Hg [T1] and 12+/-10 mm Hg [T2]) remained unchanged compared with the baseline. CONCLUSION: It is concluded that low-dose dopexamine improves PtissO2 at the serosal side of the gut, preferably at the small bowel. However, low-dose dopexamine did not improve gastric PmucCO2.

Abdomen↗