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July 13, 1979, Vol 242, No. 2 >
ARTICLE | July 13, 1979

Treatment of Circulatory Shock With Dopamine: Title and subTitle BreakStudies on Survival FREE

Carlos E. Ruiz, MD, PhD; Max Harry Weil, MD, PhD; Richard W. Carlson, MD, PhD
[+] Author Affiliations

Reprint requests to Institute of Critical Care Medicine, University of Southern California School of Medicine, 1300 N Vermont Ave, Los Angeles, CA 90027 (Dr Weil).


JAMA. 1979;242(2):165-168. doi:10.1001/jama.1979.03300020035022
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References

Therapeutic effects of dopamine hydrochloride on the peripheral and metabolic defects of shock were investigated in 34 patients with circulatory shock associated with myocardial infarction, bacteremia, or hypovolemia. Severity of the circulatory defect characterized by hypotension, reduced cardiac output, oliguria, and notably reduced skin (toe) temperature before treatment with dopamine was not directly related to survival. However, the arterial blood concentration of lactate before treatment with dopamine indicated the likelihood of survival. Patients who ultimately survived following treatment with dopamine had normal or only mildly elevated levels of arterial blood lactate before therapy. No patients with established shock states in whom perfusion failure was associated with substantial increases in the level of arterial blood lactate survived regardless of treatment with dopamine. Increases in toe temperature during dopamine treatment also emerged as a uniquely good indicator of favorable outcome during therapy.

(JAMA 242:165-168, 1979)

REFERENCES

1 +
Kurland GS, Malach M:  The clinical use of norepinephrine in the treatment of shock accompanying myocardial infarction and other conditions . N Engl J Med 247:383-389, 1952;.
2 +
Weil MH:  Clinical studies on a vasopressor agent, metaraminol (Aramine): II. Observations on its use for the management of shock . Am J Med Sci 230:357-369, 1955;.
3 +
Goldberg LI, Cotton MV, Darby TD, et al:  Comparative heart contractile force effects of equipressor doses of several sympathomimetic amines . J Pharmacol Exp Ther 108:177-185, 1953;.
4 +
Sarnoff SJ, Case RB, Berglund E, et al:  Ventricular function: V. The circulatory effects of Aramine: Mechanisms of action of "vasopressor" drugs in cardiogenic shock . Circulation 10:84-93, 1954;.
5 +
Udhoji VN, Weil MH:  Vasodilator action of a "pressor amine," mephentermine (Wyamine) in circulatory shock . Am J Cardiol 16:841-846, 1965;.
6 +
Kardos GG:  Isoproterenol in the treatment of shock due to bacteremia with Gram-negative pathogens . N Engl J Med 274:868-873, 1966;.
7 +
Smith HJ, Oriol A, Morch J, et al:  Hemodynamic studies in cardiogenic shock: Treatment with isoproterenol and metaraminol . Circulation 35:1084-1091, 1967;.
8 +
McDonald RH Jr, Goldberg LI, McNay JL, et al:  Effects of dopamine in man: Augmentation of sodium excretion, glomerular filtration rate, and renal plasma flow . J Clin Invest 43:1116-1124, 1964;.
9 +
McNay JL, Goldberg LI:  Comparison of the effects of dopamine, isoproterenol, norepinephrine and bradykinin on canine renal and femoral blood flow . J Pharmacol Exp Ther 151:23-31, 1966;.
10 +
MacCannel KL, McNay JL, Meyer MB, et al:  Dopamine in the treatment of hypotension and shock . N Engl J Med 275:1389-1398, 1966;.
11 +
Winslow EJ, Loeb HS, Rahimtoola SH, et al:  Hemodynamic studies and results of therapy in 50 patients with bacteremic shock . Am J Med 54:421-432, 1973;.
12 +
Talley RC, Goldberg LI, Johnson CE, et al:  A hemodynamic comparison of dopamine and isoproterenol in patients in shock . Circulation 39:361-378, 1969;.
13 +
Loeb HS, Winslow EBJ, Rahimtoola SH, et al:  Acute hemodynamic effects of dopamine in patients with shock . Circulation 44:163-173, 1971;.
14 +
Udhoji VN, Weil MH:  Circulatory effects of angiotensin, levarterenol, metaraminol in the treatment of shock . N Engl J Med 270:501-505, 1964;.
15 +
Cohn JN, Luria MH:  Studies in clinical shock and hypotension: II. Effects of norepinephrine and angiotensin . J Clin Invest 44:1494-1504, 1965;.
16 +
Weil MH, Afifi AA:  Experimental and clinical studies on lactate and pyruvate as indicators of the severity of acute circulatory failure . Circulation 41:989-1001, 1970;.
17 +
Joly HR, Weil MH:  Temperature of the great toe as an indication of the severity of shock . Circulation 39:131-138, 1969;.
18 +
Weil MH, Shubin H, Rosoff L:  Fluid repletion in circulatory shock: Central venous pressure and other practical guides . JAMA 192:668-674, 1965;.
19 +
Marbach EP, Weil MH:  Rapid enzymatic measurement of blood lactate and pyruvate: Use and significance of metaphosphoric acid as a common precipitant . Clin Chem 13:314-325, 1967;.
20 +
Afifi AA, Chang PC, Liu VY, et al:  Prognostic indexes in acute myocardial infarction complicating shock . Am J Cardiol 33:826-832, 1974;.

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1 +
Kurland GS, Malach M:  The clinical use of norepinephrine in the treatment of shock accompanying myocardial infarction and other conditions . N Engl J Med 247:383-389, 1952;.
2 +
Weil MH:  Clinical studies on a vasopressor agent, metaraminol (Aramine): II. Observations on its use for the management of shock . Am J Med Sci 230:357-369, 1955;.
3 +
Goldberg LI, Cotton MV, Darby TD, et al:  Comparative heart contractile force effects of equipressor doses of several sympathomimetic amines . J Pharmacol Exp Ther 108:177-185, 1953;.
4 +
Sarnoff SJ, Case RB, Berglund E, et al:  Ventricular function: V. The circulatory effects of Aramine: Mechanisms of action of "vasopressor" drugs in cardiogenic shock . Circulation 10:84-93, 1954;.
5 +
Udhoji VN, Weil MH:  Vasodilator action of a "pressor amine," mephentermine (Wyamine) in circulatory shock . Am J Cardiol 16:841-846, 1965;.
6 +
Kardos GG:  Isoproterenol in the treatment of shock due to bacteremia with Gram-negative pathogens . N Engl J Med 274:868-873, 1966;.
7 +
Smith HJ, Oriol A, Morch J, et al:  Hemodynamic studies in cardiogenic shock: Treatment with isoproterenol and metaraminol . Circulation 35:1084-1091, 1967;.
8 +
McDonald RH Jr, Goldberg LI, McNay JL, et al:  Effects of dopamine in man: Augmentation of sodium excretion, glomerular filtration rate, and renal plasma flow . J Clin Invest 43:1116-1124, 1964;.
9 +
McNay JL, Goldberg LI:  Comparison of the effects of dopamine, isoproterenol, norepinephrine and bradykinin on canine renal and femoral blood flow . J Pharmacol Exp Ther 151:23-31, 1966;.
10 +
MacCannel KL, McNay JL, Meyer MB, et al:  Dopamine in the treatment of hypotension and shock . N Engl J Med 275:1389-1398, 1966;.
11 +
Winslow EJ, Loeb HS, Rahimtoola SH, et al:  Hemodynamic studies and results of therapy in 50 patients with bacteremic shock . Am J Med 54:421-432, 1973;.
12 +
Talley RC, Goldberg LI, Johnson CE, et al:  A hemodynamic comparison of dopamine and isoproterenol in patients in shock . Circulation 39:361-378, 1969;.
13 +
Loeb HS, Winslow EBJ, Rahimtoola SH, et al:  Acute hemodynamic effects of dopamine in patients with shock . Circulation 44:163-173, 1971;.
14 +
Udhoji VN, Weil MH:  Circulatory effects of angiotensin, levarterenol, metaraminol in the treatment of shock . N Engl J Med 270:501-505, 1964;.
15 +
Cohn JN, Luria MH:  Studies in clinical shock and hypotension: II. Effects of norepinephrine and angiotensin . J Clin Invest 44:1494-1504, 1965;.
16 +
Weil MH, Afifi AA:  Experimental and clinical studies on lactate and pyruvate as indicators of the severity of acute circulatory failure . Circulation 41:989-1001, 1970;.
17 +
Joly HR, Weil MH:  Temperature of the great toe as an indication of the severity of shock . Circulation 39:131-138, 1969;.
18 +
Weil MH, Shubin H, Rosoff L:  Fluid repletion in circulatory shock: Central venous pressure and other practical guides . JAMA 192:668-674, 1965;.
19 +
Marbach EP, Weil MH:  Rapid enzymatic measurement of blood lactate and pyruvate: Use and significance of metaphosphoric acid as a common precipitant . Clin Chem 13:314-325, 1967;.
20 +
Afifi AA, Chang PC, Liu VY, et al:  Prognostic indexes in acute myocardial infarction complicating shock . Am J Cardiol 33:826-832, 1974;.

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