Harms of Low dose dopamine !!!

Despite more than thirty years of use as a renal vasodilator , low dose dopamine (2Mic/kg/m) has shown no evidence of benefit in patients with acute oliguric renal failure on the basis of its action on dopaminergic renal receptors . In fact , low -dose dopamine can have deleterious effects on hemodynamics ( decreased splanchnic blood flow ) immune function ( inhibition of T-cell lymphocyte function ) and endocrine function ( inhibition of thyroid _stimulating hormone release from the pituitary ) .
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Greet van den Berghe’s work shows neuroendocrine dysfunction as well as immunological modulation secondary to prolactin

-Reasons Dopamine is Bad

-Does not benefit the renal system

-Induces Natriuresis and Diuresis

-Shunts blood away from outer medulla, which is the region most prone to ischemic damage

-Possible induction of decreased splanchnic perfusion

-Decreases GI Motility

-Impairs ventilatory response to hypoxemia and hypercapnia

-Effects on anterior pituitary–decreases prolactin secretion

 

References :
1- (Anesth & Analg, 2004, 98,461-468)

2- The ICU book , third edition , Paul L , Marino 

3- [Neurohormonal effects following treatment with dopamine. More advantages or disadvantages?].

4- Bad medicine 

5- Friedrich, MD, DPhil; Neill Adhikari, MD, CM; Margaret S. Herridge, MD, MPH; and Joseph Beyene, PhD Ann Intern Med 5 April 2005 | Volume 142 Issue 7 | Pages 510-524 Renal dose also causes a. fib in post op pts (Crit Care Med 2005;33:1327)

6- (Crit Care Med 2006;34(3):589)