Effect of Dobutamine on Hepatic Blood Flow During Goal-directed Hemodynamic Therapy
Status:
Recruiting
Trial end date:
2022-12-01
Target enrollment:
Participant gender:
Summary
Maintaining adequate perfusion pressure and oxygen supply is essential for organ survival.
Splanchnic hypoperfusion during the perioperative period in abdominal surgery may result in
mucosal ischemia with increased permeability of the gut barrier. Additionally, the liver is
also sensitive for hypoxemia and hypoperfusion, especially during liver surgery.
Anesthetics (such as propofol or sevoflurane) have a cardiovascular depressant effect,
resulting in a reduction of cardiac output (CO). Dobutamine is used to counteract myocardial
depressant effect of anesthetics. Additionally, dobutamine is frequently used during
abdominal surgery to maintain splanchnic perfusion.
Dobutamine could increase hepatic blood flow (HBF) indirectly by increasing cardiac output or
directly by stimulating adrenergic receptors in the splanchnic circulation. The hepatic
circulation has a large number of alpha and beta adrenergic receptors and could be sensitive
for adrenergic stimulation such as dobutamine. Hence, dobutamine could have a direct effect
on the hepatic vasculature.
The aim of the study is to evaluate the effect of dobutamine on hepatic blood flow during
goal directed hemodynamic therapy and to distinguish between potential direct and indirect
effects.