Twenty-one RCTs (n=885) were included.
In terms of study quality, the validity scores ranged from 2 to 10 out of 11 (median 6) and the sample size ranged from 5 to 286 (median 30).
Effect of dopexamine on hepatosplanchnic perfusion.
There were 3 RCTs (n=74) of patients undergoing elective infrarenal aortic surgery. The number of patients with histology suggestive of mucosal ischaemia was significantly decreased with dopexamine compared with control (1 RCT, n=30). There was no significant difference between dopexamine and control for gastric mucosal pHi (1 RCT, n=20) or post- operative gut permeability (1 RCT, n=24).
There were 7 RCTs of patients undergoing major abdominal surgery. Two studies showed conflicting results for the effects of dopexamine compared with control on gastric pHi; one high-quality study (n=30) showed a significant benefit with dopexamine, while the other (n=38) showed no significant difference. One study (n=286) found dopexamine only improved gastric mucosal pHi in patients with a pre-operative pHi of less than 7.35. Other studies showed no significant difference between treatments. Two crossover studies reported benefits with dopexamine for mucosal blood flow (1 RCT, n=5) and hepatic venous oxygen saturation (1 RCT, n=17).
There were 5 RCTs (n=142) of patients undergoing cardiac surgery. Three studies found no benefit for dopexamine compared with control. One crossover study (n=14) showed significant improvement in jejunal mucosal blood flow benefit with dopexamine, while the other (n=30) showed no significant difference in liver blood flow.
There were 3 RCTs (n=154) of critically ill patients. None of the RCTs found any benefit for dopexamine.
Effect of dopexamine on renal perfusion.
There were 4 RCTs (n=144) of patients undergoing elective high-risk surgery. One of the 3 RCTs measuring creatinine clearance reported a significant benefit with dopexamine in patients undergoing cardiac surgery compared with control (n=44). One RCT (n=20) found no significant difference between treatments in renal vascular resistance.
The single RCT (n=102) of critically ill patients found no significant difference between treatments in renal vascular resistance.