Guidelines for Complications of Cancer Treatment Vol VIII Part B

participating intensive-care units (ICUs) were randomlyassigned a continuous intravenous infusion of low-dosedopamine (2 microg kg(-1) min(-1)) or placebo administeredthrough a central venous catheter while in the ICU. The primaryendpoint was the peak serum creatinine concentration duringthe infusion. Analyses excluded four patients with majorprotocol violations. FINDINGS: The groups assigneddopamine (n=161) and placebo (n=163) were similar in termsof baseline characteristics, renal function, and duration of trialinfusion. There was no difference between the dopamine andplacebo groups in peak serum creatinine concentration duringtreatment (245 [SD 144] vs 249 [147] micromol/L; p=0.93),in the increase from baseline to highest value during treatment(62 [107] vs 66 [108] micromol/L; p=0.82), or in the numbersof patients whose serum creatinine concentration exceeded300 micromol/L (56 vs 56; p=0.92) or who required renalreplacement therapy (35 vs 40; p=0.55). Durations of ICUstay (13 [14] vs 14 [15] days; p=0.67) and of hospital stay (29[27] vs 33 [39] days; p=0.29) were also similar. There were69 deaths in the dopamine group and 66 in the placebo group.INTERPRETATION: Administration of low-dose dopamineby continuous intravenous infusion to critically ill patients atrisk of renal failure does not confer clinically significantprotection from renal dysfunction.PMID: 11191541 [PubMed - indexed for MEDLINE]Ventilation with lower tidal volumes as compared withtraditional tidal volumes for acute lung injury and theacute respiratory distress syndrome. The AcuteRespiratory Distress Syndrome Network. [No authorslisted] N Engl J Med. 2000; 342:1301-8BACKGROUND: Traditional approaches to mechanicalventilation use tidal volumes of 10 to 15 ml per kilogram ofbody weight and may cause stretch-induced lung injury inpatients with acute lung injury and the acute respiratory distress94