Objective:To assess the effects of dopexamine on splanchnic blood flow and splanchnic oxygen uptake in septic patients.Design:A prospective, controlled trial.Setting:A ten-bed intensive care unit (ICU) in a university hospital.Patients:Twelve patients with severe sepsis (according to the criteria of the 1992 American College of Chest Physicians/Society of Critical Care Medicine consensus conference) being stabilized by volume loading and treated to an elevated oxygen delivery by dobutamine infusion.Interventions:Infusion of increasing dosages of dopexamine (0.5, 1.0, 2.0, and 4.0 μg/kg/min).Measurements and Main Results:Systemic and splanchnic hemodynamic and oxygen transport parameters as well as gastric mucosal pH (pHi) were measured. A hepatic venous catheter technique with indocyanine green dye dilution was used to determine splanchnic blood flow. Dopexamine increased global and splanchnic oxygen delivery without affecting oxygen consumption (&OV0312;O2). Splanchnic blood flow increased proportionally to cardiac output, indicating that there was no selective effect of dopexamine on the splanchnic flow. Dopexamine decreased pHi in a dose-dependent fashion in all 12 patients.Conclusions:In hemodynamically stable, hyperdynamic septic patients being treated with dobutamine, dopexamine has no selective effect on splanchnic blood flow. In fact, a decreased pHi suggests a harmful effect on gastric mucosal perfusion.