Effect of dopamine on gastrointestinal motility during critical illness
Abstract
Objective To document the action of dopamine on gastrointestinal motility in mechanically ventilated patients.Design Crossover, randomized, placebo-controlled study.Setting General intensive care unit (ICU) in a university hospital.Patients Twelve mechanically ventilated patients in a stable hemodynamic condition, with no contraindication to enteral feeding.Interventions Dopamine (4 microg/kg per minute) and placebo were infused over 8 h (4 h fasting, followed immediately by 4 h nasogastric feeding at 100 kcal per hour) on two consecutive days, in a random order. Pressure changes in the gastric antrum (four sites) and in the duodenum (two sites) were recorded by perfused catheter manometry. Each session started with the institution of dopamine or placebo infusion.Measurements and results The migrating motor complex and its three successive phases were identified (phase I, period of quiescence; phase II, period of irregular contractile activity; phase III or activity front, period of high-frequency, regular contractions). Contractions and activity fronts at each site were quantified during fasting and feeding. The mean duration of the fasting migrating motor complex was determined in the duodenum, as well as the contribution of each phase (phases I, II, III) to the length of the complete cycle. The propagation characteristics of each activity front were assessed visually. The number of contractions was lower in the antrum (p = 0.024) and phase III motor activity higher in the duodenum [incidence of activity fronts (p = 0.008); number of phase III contractions (p = 0.009)] during dopamine infusion than with placebo. These modifications observed under dopamine were related to decreased antral contractions during fasting (p = 0.050), increased incidence of activity fronts during feeding (p = 0.031), and increased number of phase III contractions during fasting (p = 0.037). In both groups (placebo and dopamine) activity fronts rarely started in the antrum, and abnormally propagated activity fronts were found in the duodenum in some patients.Conclusions Low-dose dopamine adversely affects gastroduodenal motility in mechanically ventilated critically ill patients.
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In critically ill patients, transit time is substantially slowed by various pathophysiological and therapeutic factors.
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Constipation in critically ill adults
Kim, Y., & See, K. C. (2025) · World Journal of Gastrointestinal Pathophysiology · doi:10.4291/wjgp.v16.i4.112019 · Cited by 4 · see citing works
López, J., Sánchez, C., Fernández, S. N., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-41674-5 · Cited by 3 · see citing works
“The importance of vasoconstrictors could be more related to the hemodynamic and general situation (hypotension, gastrointestinal hypoperfusion and severity of illness) than to the direct effect of these drugs on the bowel motility 1,10,11,13,21 .”
BackgroundUpdate on Vasopressors and Inotropes in Septic Shock
Rudis, M. I., & Chant, C. A. (2002) · Journal of Pharmacy Practice · doi:10.1106/jqwy-6udr-1d5q · Cited by 3 · see citing works
Effect of intravenous dopamine infusion on pituitary and thyroid function and on nephroprotection
Kobusiak−Prokopowicz, M., Ściborski, K., & Mysiak, A. (2012) · Polskie Archiwum Medycyny Wewnętrznej · doi:10.20452/pamw.1200 · Cited by 3 · see citing works
Pharmacokinetic Alterations of Antimicrobials in the Critically Ill
Cook, A. M. (2005) · Journal of Pharmacy Practice · doi:10.1177/0897190004273568 · Cited by 3 · see citing works
“Catecholamines and overactivation of the sympathetic nervous system can cause impaired gastric emptying, likely by overriding vagal tone.(12,13) Opioids are often used for sedation in critically ill patients.”
BackgroundChen, T., & Chang, F. (2013) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.12308 · Cited by 2 · see citing works
Upright position mechanical ventilation: An alternative strategy for ALI/ARDS patients?
Zhu, M., Zhang, W., Wang, J., Yan, H., Li, Y., Ai, B., Fu, S.-L., & Fu, X. (2009) · Medical Hypotheses · doi:10.1016/j.mehy.2009.03.023 · Cited by 2 · see citing works
“Medications such as dopamine and sedation [21], hyperglycemia [22] or increased intracranial pressure [23] have all been shown to depress the gut activity.”
BackgroundTherapie des Kreislaufversagens bei Sepsis
Meier‐Hellmann, A. (2007) · Steinkopff eBooks · doi:10.1007/978-3-7985-1729-5_6 · Cited by 2 · see citing works
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Narrative review of constipation in the critically ill child
López, J., Solana, M. J., & López‐Herce, J. (2021) · Pediatric Medicine · doi:10.21037/pm-20-63 · Cited by 2 · see citing works
“In addition, there are multiple and frequent factors in critically ill patients which negatively affect one or several sections of the GI tract: mechanical ventilation, analgesic drugs (opioid or non-opioid) or inotropes, splanchnic hypoperfusion, immobility and delay in the onset of enteral nutrition (EN) (5,7-9,11,1…”
BackgroundThe Microbiome and Antimicrobial Stewardship in Surgical Patients
Creel, J., & Maves, R. C. (2023) · Surgical Infections · doi:10.1089/sur.2022.422 · Cited by 2 · see citing works
“23,24 The dysmotility may favor gut colonization with pathogenic organisms, such as Pseudomonas , and subsequently increase the risk of nosocomial infection related to gastrointestinal tract pathogens.”
Understanding of Pathophysiological Basis of Feeding Intolerance in Critically ill Children
Bağcı, S., Keleş, E., & Müller, A. (2021) · Cam and Sakura Medical Journal · doi:10.4274/csmedj.galenos.2021.2021-11-1 · Cited by 1 · see citing works
“In mechanically ventilated patients with critical illness, Dive et al. (86) demonstrated that continuous intravenous administration of dopamine at a low dose (4 µg/kg per min) decreased the number of contractions in the gastric antrum and induced phase III motor activity in the duodenum both during…”
BackgroundUse of Gastric Decompression Tubes With Small-Bowel Feeding Tubes
Powers, J. (2014) · Critical Care Nurse · doi:10.4037/ccn2014317 · Cited by 1 · see citing works
- Authors
- Dive, A., Foret, F., Jamart, J., Bulpa, P., & Installé, E.
- Affiliations
- UCLouvain (BE)
- Venue
- Intensive Care Medicine
- Published
- 2000-07-28
- Volume
- 26
- Issue
- 7
- Pages
- 901-907
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- OpenAlex
- W2008260145
- Cited by
- 124
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 3 · 2022: 4 · 2021: 8 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 8 · 2016: 3 · 2015: 7 · 2014: 6 · 2013: 1 · 2012: 10
- FWCI
- 5.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Intensive Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- dopamine, gastrointestinal motility, migrating motor complex, gastroduodenal motility, mechanical ventilation, critically ill patients, enteral nutrition, gastric antrum, duodenum
- MeSH terms
- Adult, Aged, Dopamine, Duodenum, Enteral Nutrition, Female, Gastrointestinal Motility, Humans, Male, Manometry, Middle Aged, Pyloric Antrum, Respiration, Artificial, Vasodilator Agents, Myoelectric Complex, Migrating, Critical Illness, Cross-Over Studies, Statistics, Nonparametric
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