Intravenous dopamine in the treatment of myocardial dysfunction after open-heart surgery

Abstract Intravenous dopamine (6 to 33 μg per kilogram per minute) was administered to 15 consecutive patients developing hypotension after corrective valve surgery or saphenous vein bypass grafts. All were unresponsive to one or more of the usual inotropic agents (norepinephrine, metaraminol, isoproterenol, epinephrine, and glucagon). Ten of the 15 patients had adequate blood pressure restoration, increase in urine flow, and decrease in peripheral vasoconstriction. Of the 9 who no longer required dopamine for cardiovascular support, 6 were discharged from the hospital and remain well, 2 died of cerebral complications, and one of hyperkalemic cardiac arrest. One patient initially responded, but died during drug therapy. Five patients, unresponsive to dopamine as well as other pharmacologic agents, died. Dopamine was used continuously for over 60 hours in 5 patients and in concentrations greater than 20 μg per kilogram per minute in 8 patients. The data indicate that dopamine is a useful catecholamine in the treatment of patients with low cardiac output states after open-heart surgery.