Effect of dopamine on renal function in the patients with acute severe pancreatitis complicated with septic shock

    XIONG Dongª²Fang, LI Shuª²Xia, HOU Liª²Chao, HUANG Yi, XIONG Liª²Ze, CHEN Shaoª²Yang, CHEN Min, GONG Gu, ZHU Xiaoª²Ling, WANG Yaª²Li, HU Wenª²Neng

    Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi¬ðan 710033, China, Department of Anesthesiology, Central Hospital of Luohe City, Luohe 462000, China

    ¡¾Abstract¡¿ AIM: To study the effect of dopamine on the renal function in the patients with acute severe pancreatitis complicated with septic shock. METHODS: Thirtyª²nine patients with acute severe pancreatitis complicated with septic shock were divided into 3 groups according to the maximal infusing rate of dopamine used: group A, n=14, 2-9 ¦Ìg/(kg¡¤min); group B, n=14, 10-15 ¦Ìg/(kg¡¤min); and group C, n=11, >15 ¦Ìg/(kg¡¤min). Mean arterial blood pressure(MAP), heart rate(HR), urine output, blood urea nitrogen(BUN), creatinine(CRE), urine albumin(Uª²ALB) and urine ¦Â2ª²microglubulin (U¦Â2ª²MG) as well as APACHE III scores were detected and recorded for all the patients. RESULTS: Before antiª²shock therapy, hypotension, tachycardia and oliguria occurred to all 39 patients with acute severe pancreatitis complicated with septic shock, and CRE, BUN, Uª²ALB, U¦Â2ª²MG and APACHE III scores were above the normal in most cases. After antiª²shock therapy, MAP, HR, urine output and BUN, CRE in all patients from the 3 groups gradually returned to their normal levels(P<0.05 vs those before antiª²shock therapy), and Uª²ALB, U¦Â2ª²MG output and APACHE III scores also restored but still remained in their abnormal levels (P<0.01 vs those before antiª²shock therapy). CONCLUSION: The first goal to treat the patients with acute severe pancreatitis complicated with septic shock should be the restoration of the organ blood supply, and based on volume resuscitation. Dopamine and other vasoactive drugs could be adjunctively used to maintain circulatory stability. ......