Case File-5

A 65-year-old woman is admitted in ICU of the hospital with sepsis caused by a urinary tract infection. She is hypotensive, with a BP of 80/40 mm hg and has an elevated heart rate and decreased urine output. Along with the institution of appropriate antibiotic therapy and IV fluids, a decision is made to start her on an IV infusion of dopamine to attempt to raise her BP

Questions 1. What effects can be expected with low

dose dopamine?2. Which receptors mediate these

effects?3. What effects occur with higher dose

dopamine and which receptors mediate these?

Summary A 65-year-old woman in septic shock

has persistent hypotension and oliguria requiring IV dopamine

Effects of low dose dopamineReduces arterial resistanceIncreases blood flow in renal,

coronary, and splanchnic systems;Positive inotropic effect

Receptors involvedBeta 1 receptors Specific dopamine receptors

Effects of higher dose dopamine and receptors involved

Vaso constriction mediated by alpha receptors