Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-27T18:33:35.307Z Has data issue: false hasContentIssue false

Prehospital Treatment with Dobutamine

Published online by Cambridge University Press:  28 June 2012

Bjarne Oberg*
Affiliation:
The Mobile Intensive Care Unit, The Municipal Hospital, DK-1399, Copenhagen, Denmark
Mogens Bredgaard Sorensen
Affiliation:
The Mobile Intensive Care Unit, The Municipal Hospital, DK-1399, Copenhagen, Denmark
*
Hans Jensensvej 12, DK-2900 Hellerup, Denmark

Abstract

Purpose:

To assess the effectiveness of the use of dobutamine hydrochloride in out-of hospital emergency situations.

Population:

Patients with severe circulatory insufficiency caused by acute illness or injury encountered by the Mobile Intensive Care Unit of Copenhagen (population 467,000) during a 15-month study period.

Methods:

A newly developed dobutamine solution was administered by infusion pump to patients in whom normal emergency treatment failed to restore an acceptable circulatory state.

Results:

A total of 40 patients were treated with 4–48 μg dobutamine/kg/minute. The treatment was judged to be primary life-saving in 15 patients, the condition was improved in 16 patients, and nine patients died. Systolic blood pressures (in those who survived) rose from a mean value of 45 mmHg (range 0–80 mmHg) to 105 mmHg (range 65–180 mmHg). No tachycardia or arrhythmias were noted.

Conclusion:

This newly developed dobutamine solution is very useful in prehospital treatment of patients with circulatory failure and is recommend for use by mobile intensive care unit teams.

Type
Brief Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Tuttle, RR, Mills, J: Development of a new catecholamine to selectively increase cardiac contractivity. Circ Res 1975;36:185196.Google Scholar
2. Stoner, JD, Bolen, JL, Harrison, DC: Comparison of dobutamine and dopamine in treatment of severe heart failure. Br Heart J 1977;39:536539.CrossRefGoogle ScholarPubMed
3. Gillespie, TA, Ambos, HD, Sobel, BE, et al. : Effects of dobutamine in patients with acute myocardial infarction. Am J Cardiol 1977;39:588594.CrossRefGoogle ScholarPubMed
4. Roberts, R: Inotropic therapy for cardiac failure associated with acute myocardial infarction. Chest 1988;93:225245.CrossRefGoogle ScholarPubMed
5. Leier, CV: Acute inotropic support. In Cardiotonic Drugs p 4984 Marcel Deccer Inc., New York, Basel 1986.Google Scholar
6. Rude, RE, Izquierdo, C, Buja, LM, Willerson, JT: Effects of inotropic and chronotropic stimuli on acute myocardial ischemic injury. I. Studies with dobutamine in the anesthetized dog. Circulation 1982;65:13211328.Google Scholar
7. Maekawa, K, Chang-Seng, L, Hood, WB: Comparison of dobutamine and dopamine in acute myocardial infarction. Circulation 1983;67:750759.Google Scholar
8. Liang, C, Yi, JM, Sherman, LG, et al. : Dobutamine infusion in conscious dogs with and without acute myocardial infarction. Effects of systemic hemody namics, myocardial blood flow and infarct size. Circ Res 1981;49:170180.Google Scholar
9. Jensen, K, Bunemann, L: Cerebral blood flow in patients treated with dobutamine after cardiopulmonary resuscitation. Proceedings from the 10th International Symposium on Intensive Care and Emergency Medicine, Brussels 27–30 March 1990, p 34.Google Scholar
10. Michenfelder, JD, Milde, JH: Postischemic canine cerebral blood flow appears to be determined by cerebral metabolic needs. J Cereb Blood Flow Metab 1990;10:7176.CrossRefGoogle ScholarPubMed
11. Reynolds, JEF: Doubtamine Hydrochloride. In Marlindale, 29th ed. London: The Pharmaceutical Press, 1989, pp 14591460.Google Scholar