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Effects of increasing infusion rates of dopamine, dobutamine, epinephrine, and phenylephrine in healthy anesthetized cats

Peter J. Pascoe BVSc1, Jan E. Ilkiw BVSc, PhD2, and Bruno H. Pypendop Dr Med Vet, Dr Vet Sci3
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  • 1 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 2 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 3 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

Abstract

Objective—To determine the cardiopulmonary effects of increasing doses of dopamine, dobutamine, epinephrine, and phenylephrine and measure plasma concentrations of norepinephrine, epinephrine, and dopamine in cats anesthetized with isoflurane.

Animals—6 healthy adult cats.

Procedures—Each cat was anesthetized with isoflurane (1.5 X minimum alveolar concentration) on 4 occasions. Cardiopulmonary measurements were obtained after a 30-minute stabilization period; 20 minutes after the start of each infusion dose; and 30, 60, and 90 minutes after the infusion was discontinued. Cats received 5 progressively increasing infusions of epinephrine or phenylephrine (0.125, 0.25, 0.5, 1, and 2 μg/kg/min) or dobutamine or dopamine (2.5, 5, 10, 15, and 20 μg/kg/min). The order of treatment was randomly allocated.

Results—All 4 treatments increased oxygen delivery. Heart rate (HR) increased during administration of all drugs except phenylephrine, and mean arterial pressure increased during administration of all drugs except dobutamine. A progressive metabolic acidosis was detected, but whole-blood lactate concentration only increased during administration of epinephrine and dobutamine. Systemic vascular resistance index increased during administration of phenylephrine, decreased during administration of dobutamine, and remained unchanged during administration of dopamine and epinephrine. A positive inotropic effect was detected with all treatments.

Conclusions and Clinical Relevance—During anesthesia in cats, administration of dopamine, dobutamine, and epinephrine may be useful for increasing cardiac output, with dopamine having the most useful effects. Administration of phenylephrine increased cardiac and systemic vascular resistance indexes with minimal effect on HR and may be useful for increasing mean arterial pressure without increasing HR.

Abstract

Objective—To determine the cardiopulmonary effects of increasing doses of dopamine, dobutamine, epinephrine, and phenylephrine and measure plasma concentrations of norepinephrine, epinephrine, and dopamine in cats anesthetized with isoflurane.

Animals—6 healthy adult cats.

Procedures—Each cat was anesthetized with isoflurane (1.5 X minimum alveolar concentration) on 4 occasions. Cardiopulmonary measurements were obtained after a 30-minute stabilization period; 20 minutes after the start of each infusion dose; and 30, 60, and 90 minutes after the infusion was discontinued. Cats received 5 progressively increasing infusions of epinephrine or phenylephrine (0.125, 0.25, 0.5, 1, and 2 μg/kg/min) or dobutamine or dopamine (2.5, 5, 10, 15, and 20 μg/kg/min). The order of treatment was randomly allocated.

Results—All 4 treatments increased oxygen delivery. Heart rate (HR) increased during administration of all drugs except phenylephrine, and mean arterial pressure increased during administration of all drugs except dobutamine. A progressive metabolic acidosis was detected, but whole-blood lactate concentration only increased during administration of epinephrine and dobutamine. Systemic vascular resistance index increased during administration of phenylephrine, decreased during administration of dobutamine, and remained unchanged during administration of dopamine and epinephrine. A positive inotropic effect was detected with all treatments.

Conclusions and Clinical Relevance—During anesthesia in cats, administration of dopamine, dobutamine, and epinephrine may be useful for increasing cardiac output, with dopamine having the most useful effects. Administration of phenylephrine increased cardiac and systemic vascular resistance indexes with minimal effect on HR and may be useful for increasing mean arterial pressure without increasing HR.

Contributor Notes

Supported by the Center for Companion Animal Health, School of Veterinary Medicine, University of California.

The authors thank Drs. Tony Yaksh and Steve Rossi for analysis of the catecholamine concentrations and Mike Rathbun for assistance with the statistical analysis.

Address correspondence to Dr. Pascoe.