Indications and Criteria for Dopamine Replacement Therapy

  • Nariyuki Hayashi
  • Dalton W. Dietrich


In severely brain-injured patients such as those with a Glasgow Coma Scale score (GCS) less than 5, unconsciousness does not lead to recovery soon after brain hypothermia treatment. Patients that open their eyes with external stimulation, offer no emotional response, and show no understanding of verbal stimulation have poor prognosis [1]. Vegetative patients require dopamine replacement therapy. The indications for dopamine replacement therapy are:
  • Persistent coma

  • Vegetative state

  • Expressive response around eye and mouth after tapping stimulation

  • Low cerebrospinal fluid (CSF) dopamine level

  • Response of CSF dopamine/prolactin ratio to treatment


Vegetative State Glasgow Coma Scale Score External Stimulation Cerebral Microcirculation Dopamine Replacement Therapy 
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  1. 1.
    Hayashi N (1997) Combination therapy of cerebral hypothermia, pharmacological activation of the dopamine system, and hormonal replacement in severely brain damaged patients. J Jpn Soc Intensive Care Med 4:191–197CrossRefGoogle Scholar
  2. 2.
    Hayashi N (2000) The clinical issue and effectiveness of brain hypothermia treatment for severe brain injured patients. In: Hayashi N (ed) Brain hypothermia. Springer, Berlin Heidelberg New York Tokyo, pp 121–151CrossRefGoogle Scholar

Copyright information

© Springer Japan 2004

Authors and Affiliations

  • Nariyuki Hayashi
    • 1
    • 2
  • Dalton W. Dietrich
    • 3
    • 4
  1. 1.Nihon University Emergency Medical CenterTokyoJapan
  2. 2.Department of Emergency and Critical Care MedicineNihon University School of MedicineTokyoJapan
  3. 3.Department of Neurological Surgery, Neurology and Cell Biology and AnatomyUniversity of Miami School of MedicineMiamiUSA
  4. 4.The Miami Project to Cure ParalysisMiamiUSA

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