Dopamine is still frequently used as a first line
vasopressor agent in hypotensive patients, when physicians
are afraid of noradrenaline and believe that dopamine, with
its β and α, inotrope and vasopressor effects, may be helpful.
Evidence exists that it does not offer protection from renal
failure, even if at low doses (0, 3-5 mcg/Kg/min) it may exert
its effects on D1 and D2 receptors resulting in natriuresis and
renal vasodilation, augmentation in renal blood flow, and
diuresis.
The effects of dopamine on gastrointestinal system and
splanchnic perfusion in critical care patients are even more
controversial, since they seem to be at least partially
dependent on the initial fractional splanchnic blood flow.
Dopamine may exert deleterious effects on respiratory
function, by impairing the ventilatory drive response to
hypoxemia and hypercapnia and reducing arterial oxygen
saturation through a regional ventilation/perfusion
mismatching. Dopamine seems to affect the cellular mediated
mechanism of the immune function directly by its action on
receptors located on immune system cells and indirectly
altering the hormonal response regulating immune response.
In this paper, the use of low dose dopamine is discussed in the
intensive care perspective
