黄芪注射液对原发性慢性肾小球疾病的治疗作用

目的:观察黄芪注射液辅助治疗慢性肾小球疾病的临床疗效.方法:随机将66例慢性肾小球疾病患者分为对照组(33例)和黄芪注射液治疗组(33例).对照组按原发性肾小球疾病常规治疗,治疗组在常规治疗的同时加用黄芪注射液,疗程14 d.分别在治疗前及14 d疗程后观察并记录血常规、24 h尿蛋白定量、血浆总蛋白、白蛋白、血尿素氮、肌酐、血总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白及血压.结果:黄芪注射液治疗组24 h尿蛋白定量明显降低(P＜0.01),血总蛋白及白蛋白明显升高(P＜0.01,P＜0.05),总胆固醇、甘油三酯、低密度脂蛋白明显降低(P＜0.05),高密度脂蛋白、血压、红细胞及血红蛋白比较无统计学差异(P＞0.05).结论:黄芪注射液不仅能明显的降低蛋白尿,而且具有降低血脂及升高血浆蛋白作用.     

黄葵联合金水宝治疗慢性肾小球肾炎轻中度蛋白尿的临床研究

目的：研究观察黄葵胶囊联合金水宝胶囊治疗慢性肾小球肾炎轻中度蛋白尿疗效。方法：入选180例患者诊断为慢性肾小球肾炎,同时血压控制在125/75mmHg以下,24h尿蛋白定量0.5～2.0g,血肌酐正常。随机分为治疗组90例,对照组90例。治疗组应用黄葵胶囊联合金水宝胶囊,对照组应用金水宝胶囊。监测治疗0周、2周、4周、6周、8周24h尿蛋白定量变化、肝肾功能。结果：治疗组在治疗4周时平均尿蛋白量下降,对照组在治疗6周时平均尿蛋白量下降,治疗8周时治疗组尿蛋白较对照组显著下降。治疗期间两组肾小球滤过率略有升高,两组间差异无统计学意义。结论：黄葵胶囊联合金水宝胶囊治疗慢性肾小球肾炎轻中度蛋白尿较单用金水宝胶囊起效快、疗效好,不良反应轻微。     

咪唑立宾治疗儿童紫癜性肾炎的临床观察

目的探讨咪唑立宾(mizoribine,MZR)治疗儿童紫癜性肾炎的安全性及疗效。方法纳入33例紫癜性肾炎(Ⅱb级)患儿,按其治疗方案不同分为2组:治疗组18例给予口服咪唑立宾片治疗(剂量2.5～3 mg·kg~(-1)·d~(-1)),治疗3个月后逐渐减量。对照组15例给予口服泼尼松片(1 mg·kg~(-1)·d~(-1))联合吗替麦考酚酯片(剂量20～30 mg·kg~(-1)·d~(-1)),治疗3个月后逐渐减量。两组疗程均为9～12个月,观察两组血常规、尿常规、24 h尿蛋白定量、血清白蛋白、肝肾功能及药物不良反应。结果治疗后,治疗组与对照组临床总有数率相当。两组治疗后24 h尿蛋白定量均低于治疗前,血清白蛋白水平均高于治疗前,差异有统计学意义(P0.05),血丙氨酸转氨酶、血肌酐及血尿酸变化差异无统计学意义(P0.05)。治疗组仅有2例在治疗初期出现轻微皮疹的不良反应。对照组不良反应有上呼吸道感染3例,白细胞下降3例,腹泻1例,恶心、呕吐1例。结论 MZR治疗临床表现为中度蛋白尿的紫癜性肾炎患儿,具有一定临床疗效,其疗效与泼尼松联合吗替麦考酚酯片相当,但其治疗更为简单经济、不良反应少,为儿童紫癜性肾炎的治疗提供了一种新的方案。     

黄葵胶囊联合缬沙坦治疗非IgA系膜增生性肾小球肾炎轻中度蛋白尿的临床研究

目的:观察黄葵胶囊联合缬沙坦治疗非IgA系膜增生性肾小球肾炎轻中度蛋白尿的疗效。方法:将96例非IgA系膜增生性肾小球肾炎患者随机分为黄葵胶囊联合缬沙坦组(治疗组)和单用缬沙坦组(对照组),分别检测两组治疗前后24 h尿蛋白定量、血清白蛋白、血肌酐,并进行组间比较。结果:治疗组临床疗效总有效率显著高于对照组(P<0.01)。治疗组与对照组均能显著降低24 h尿蛋白(P<0.01),两组比较差异有统计学意义(P<0.01)。治疗组与对照组均能显著提高血清白蛋白(P<0.05),但两组比较差异无统计学意义(P>0.05)。结论:黄葵胶囊联合缬沙坦治疗非IgA系膜增生性肾小球肾炎比单用缬沙坦能更显著地降低尿蛋白排泄量,未见明显不良反应。     

厄贝沙坦治疗慢性肾小球肾炎的临床疗效观察

目的:探讨厄贝沙坦治疗慢性肾小球肾炎的疗效。方法:将收治的80例慢性肾小球肾炎患者随机分为治疗组(40例)和对照组(40例),治疗组予以口服厄贝沙坦治疗,对照组予以口服卡托普利治疗,分别于治疗后每2周对两组患者的血压、24h尿蛋白排泄量、肾功能等进行观察。结果:治疗组和对照组的有效率分别为90.00%和77.50%,两组比较差异有统计学意义(P<0.05)。治疗后与治疗前相比,治疗组与对照组在血压、24h尿蛋白、血肌酐等指标上均有所下降,并且两组差距具有统计学意义(P<0.05)。结论:厄贝沙坦治疗慢性肾小球肾炎疗效显著,可进行临床推广应用。     

肾炎消白颗粒对糖尿病肾病大鼠肾组织nephrin-mRNA表达的影响

目的:通过实验观察肾炎消白颗粒对糖尿病肾病(DN)模型大鼠肾组织nephrin-mRNA、podocin-mRNA表达的影响,探讨肾炎消白颗粒防治DN的机制。方法:采用高糖、高脂饮食加切除单侧肾脏联合一次性腹腔注射链脲佐菌素(STZ)的方法建立DN大鼠模型~([1]),将大鼠随机分为空白对照组、模型对照组、盐酸贝那普利(洛汀新)组、肾炎消白颗粒高剂量组、肾炎消白颗粒低剂量组共计5组。连续灌胃8周后,检测大鼠尿微量白蛋白(m Alb);采用实时荧光定量PCR法检测大鼠肾组nephrin-mRNA、podocin-mRNA的表达。结果:肾炎消白颗粒能明显降低尿m Alb,与模型组比较差异有统计学意义(P0.05),并以低剂量组更为明显,低剂量组与洛汀新组比较差异有统计学意义(P0.05);与空白组相比,模型组大鼠肾组织nephrin-mRNA、podocin-mRNA表达水平显著降低(P0.05);经肾炎消白颗粒治疗后,与模型对照组比较,大鼠肾组织nephrin-mRNA、podocin-mRNA表达水平显著升高(P0.05)。结论:肾炎消白颗粒可通过上调nephrin-mRNA、podocin-mRNA的表达,降低尿蛋白的排出,达到保护肾脏的目的,延缓模型大鼠糖尿病肾病进展。     

黄芪注射液对慢性肾脏病疗效和血管内皮生长因子及其可溶性受体的影响

目的:观察黄芪注射液对慢性肾脏病疗效和血管内皮生长因子及其可溶性受体的影响。方法:将80例慢性肾脏病分成治疗组和对照组,两组均采用一般基础治疗,治疗组加用黄芪注射液,静脉滴注2周,2周后观察临床疗效、中医症状积分和血压、血糖、血脂、肾功能、24 h尿蛋白定量、VEGF、s Flt-1等指标。结果:治疗组总有效率87.8%,对照组总有效率64.1%,两组差异有统计学意义(P0.05);治疗组临床症状改善明显优于对照组,特别是神疲乏力、腰膝酸软方面;两组治疗后血压、血糖、血脂、肾功能、24 h尿蛋白定量均有下降(P0.05),治疗组治疗后血肌酐、血胱抑素C、24 h尿蛋白定量较对照组治疗后差异有统计学意义(P0.05);治疗组较对照组可明显降低血清VEGF水平,升高血清s Flt1(P0.05)。结论:黄芪注射液可通过降低血清VEGF,升高血清s Flt1,减少慢性肾脏病患者蛋白尿,降低血肌酐,改善临床症状。     

肾炎消白颗粒对糖尿病肾脏病大鼠肾组织VEGF及IGF表达的影响

目的:通过实验观察肾炎消白颗粒对糖尿病肾脏病(DKD)模型大鼠血管内皮生长因子(VEGF)及胰岛素样生长因子(IGF)表达的影响,探讨肾炎消白颗粒防治DKD的机制。方法:采用高糖、高脂饮食联合单侧肾切除加一次性腹腔注射链脲佐菌素(STZ)方法建立DKD大鼠模型~([1]),将大鼠随机分为空白对照组、模型对照组、盐酸贝那普利(洛汀新)组、肾炎消白颗粒高剂量组、肾炎消白颗粒低剂量组共5组。连续灌胃8周,检测大鼠尿微量白蛋白(m Alb);采用免疫组化法检测大鼠肾组织VEGF及IGF的表达。结果:肾炎消白颗粒能明显降低尿m Alb,与模型组比较差异有统计学意义(P0.05),并以低剂量组更为明显,低剂量组与洛汀新组比较差异有统计学意义(P0.05);与空白组相比,模型组大鼠肾组织VEGF与IGF表达水平显著升高(P0.05);经肾炎消白颗粒治疗后,与模型对照组比较,大鼠肾组织VEGF与IGF表达水平显著下降(P0.05)。结论:VEGF与IGF参与糖尿病肾脏损害的发生,肾炎消白颗粒可能通过下调VEGF与IGF的表达,降低尿蛋白的排出,达到保护肾脏的目的,延缓模型大鼠糖尿病肾脏病进展。     

枸芪复肾丸治疗慢性肾炎的临床研究

目的:观察枸芪复肾丸治疗慢性肾小球肾炎的有效性及安全性。方法:230例慢性肾小球肾炎患者随机分为治疗组和对照组,每组各115例。两组均给予盐酸贝那普利,10 mg,日1次口服;治疗组加用枸芪复肾丸,1丸,日3次口服,疗程3个月。观察两组病人症状变化及24 h尿蛋白定量、尿红细胞计数,肝、肾功能的变化。结果:(1)治疗组脱落5例,对照组脱落12例,治疗组总有效率为83.64%,对照组为47.57%,经统计学处理,差异有统计学意义(P0.01)。(2)治疗组病人治疗后腰痛、乏力、手足心热症状明显减轻(P0.05),而对照组无明显改善(P0.05);(3)治疗后两组病人24 h尿蛋白定量及尿红细胞计数均能明显降低(P0.01),但治疗组改善程度更为明显(P0.05)。(4)治疗后两组病人肝肾功能均无明显改变。结论:枸芪复肾丸能明显降低慢性肾炎病人24 h尿蛋白定量、尿红细胞计数,能改善腰痛、乏力、手足心热等症状,疗效优于盐酸贝那普利。     

sFlt-1与LAMP-2在ANCA相关性肾炎患者血清中的表达水平及其相关性分析

目的探究可溶性血管内皮细胞生长因子受体1(sFlt-1)与溶酶体相关膜蛋白2(LAMP-2)在抗中性粒细胞胞质抗体(ANCA)相关性肾炎患者血清中的表达水平及其相关性。方法选择2016年10月至2017年10月间90例ANCA相关性肾炎患者作为研究组,根据24h尿蛋白水平分为低蛋白尿组和高蛋白尿组。选择同期单纯慢性肾小球肾炎患者共90例作为对照组以及50例健康者作为健康组。分别比较不同组间的血清和尿液中的sFlt-1和LAMP-2水平,并分别研究sFlt-1和LAMP-2水平与ANCA相关性肾炎以及24h尿蛋白的相关性。结果研究组血清和尿液中的sFlt-1和LAMP-2水平均显著高于对照组和健康组(P0.05)。将尿液和血清中的sFlt-1和LAMP-2纳入Logistic多元回归分析,结果显示血清LAMP-2以及尿液LAMP-2是ANCA相关性肾炎的高危因素(P0.05)。在ANCA相关性肾炎患者(研究组)中,高蛋白尿组患者血清和尿液中的sFlt-1和LAMP-2水平均显著高于低蛋白尿组(P0.05),并且均显著高于健康组(P0.05)。血清和尿液中sFlt-1和LAMP-2与ANCA相关性肾炎患者24h尿蛋白呈现显著的正相关性(P0.05)。结论慢性肾小球肾炎患者血清和尿液中sFlt-1和LAMP-2水平显著升高,ANCA相关性肾炎患者LAMP-2水平显著高于慢性肾小球肾炎患者,并且血清和尿液中LAMP-2是ANCA相关性肾炎的高危因素。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.