EFFECTS OF DOPAMINE ON KIDNEY-FUNCTION
EFFECTS OF DOPAMINE ON KIDNEY-FUNCTION
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DOI：
10.1177/00359157770700s207
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发表时间：
1977-01-01
期刊：
影响因子：
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通讯作者：
SCHOEPPE, W
中科院分区：
文献类型：
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作者：
SCHOEPPE, W
我想对剂量发表一点评论，因为每个人似乎都误解了我所说的话。当我谈到小剂量的多巴胺时，我说的是充血性心力衰竭。我非常害怕增加后负荷。在休克病人中，我们滴定剂量，直到达到正确的压力水平，直到心律失常发生，或直到尿流量减少。但必须滴定剂量。我认为汤普森博士说得很清楚的一点是，不同的病人对不同的剂量有反应。狗也是如此：有些狗只需要很小剂量的多巴胺就能产生血管收缩，而有些狗则需要很大剂量的多巴胺。我认为，就感受器而言，存在着生物学上的变异性，休克患者的各种情况都会发生变化：也许肌肉的反应不那么好。如果我们有更多的时间，也许我们可以稍后讨论这个问题，因为很多人都问过我这个问题。我没有说多巴胺的剂量有任何限制。我只是想强调，对于充血性心力衰竭的患者，特别是过去有过心肌梗死的患者，为了不增加后负荷，必须非常缓慢地进行。在休克是一个不同的情况。
I want to make one comment about dosage because everyone seems to be misinterpreting what I said. When I talk about a small dose of dopamine, I am talking about congestive heart failure. There I am very much afraid of increasing afterload. In a patient with shock we titrate the dose until the right pressure level is reached, until arrhythmias occur, or until the urine flow decreases. But it is essential that the dose should be titrated. I think one point that Dr Thompson made very clearly was that different patients respond to different doses. This is the same in the dog: some dogs produce vasoconstriction with a very small dose of dopamine, and some need a very large dose. I think that there is biological variability as far as receptors are concerned, and with patients in shock there are all kinds of things that vary: perhaps the muscles are not responding so well. Perhaps we can discuss this later if we have further time, since many people have asked me about this. I did not say that there is any limit on the dose of dopamine. I was merely trying to emphasize that in a patient with congestive heart failure, particularly someone who has had myocardial infarcts in the past, one has to go very slowly in order not to increase the afterload. In shock it is a differentsituation.