Correction of Splanchnic Oxygen Deficit in the Intensive Care Unit: Dopexamine and Colloid versus Placebo

Correction of the splanchnic oxygen deficit indicated by low gastric intramucosal pH (pH_i < 7.35) appears to reduce ICU mortality. Dopexamine hydrochloride is in clinical use for this purpose but its efficacy has not been fully investigated. We report the results of a prospective, randomized, placebo-controlled study with a crossover design to assess the efficacy of dopexamine in correcting low pH_i. Twelve patients in whom pH_i < 7.32 was detected during eight-hourly monitoring were randomized to receive either incremental dopexamine (4-6 μg/kg/min) with colloid or 5% dextrose for three hours prior to crossover. There was no difference in pH_i between treatments despite cardiovascular effects during dopexamine infusion. There was, however, a time-related increase in pH_i suggesting a beneficial effect of conventional therapy. Dopexamine hydrochloride at 4-6 μg/kg/min in conjunction with colloid is not a clinically useful therapy to correct the splanchnic oxygen deficit indicated by low pH_i.