Effects of Dobutamine on Gastric Mucosal Perfusion and Hepatic Metabolism in Patients with Septic Shock

We prospectively evaluated the effects of dobutamine on gastric mucosal perfusion and hepatocytic clearance in patients with septic shock. After resuscitation with volume expansion and norepinephrine (12 patients) as needed, 14 hemodynamically stable patients (median age: 60 yr, median SAPS II score: 47) were given an infusion of 7.5 μ g/kg/min dobutamine for 1 h. Gastric mucosal perfusion and hepatocytic clearance were assessed with tonometry and indocyanine green (ICG) elimination, respectively. All measurements were made before dobutamine infusion, after 1 h of dobutamine infusion, and 1 h after the infusion ended. Cardiac output (thermodilution technique) increased with dobutamine from a baseline median level of 4.0 L/min/m2 (range: 1.7 to 7.4 L/min/m2) to 5.0 L/min/m2 (range: 3.5 to 8.9 L/min/m2) (p = 0.004) and returned to baseline levels after dobutamine infusion ended. The gastric–arterial Pco 2 difference decreased from a baseline median level of 13 mm Hg (range: 5 to 54 mm Hg) to 7 mm Hg (range:...