Dopamine, dopexamine and dobutamine in liver transplant recipients: A comparison of their effects on hemodynamics, oxygen transport and hepatic venous oxygen saturation

The purpose of this study was to determine the effects of vasoactive treatment with dopamine (DO), dopexamine (DX), and dobutamine (DOE) on hemodynamics, oxygen transport and hepatic venous oxygen saturation (SvhO(2)) after orthotopic liver transplantation (OLT). A pulmonary artery catheter was inserted into the right hepatic vein of 17 OLT patients. Timed infusion of DO, DX, and DOB was performed at the following rates: DO at 4 and 8 mu g/kg per minute, DX at 4 and 8 mu g/kg per minute, and DOB at 5 and 10 mu g/kg per minute. Hemodynamics, oxygen transport variables, and SvhO(2) were assessed. Each catecholamine induced a significant increase in cardiac index, oxygen delivery, and SvhO(2). Mean arterial pressure was increased during DO and DOB, but significantly reduced during DX. Each inotrope increased oxygen delivery in parallel with SvhO(2), suggesting a corresponding increase in hepatic oxygen supply. Therefore, it appears that each vasoactive drug may be utilized in OLT patients to provide oxygen delivery without impairment of splanchnic oxygenation.