Friday February 10, 2006
Norepinephrine or Dopamine ?
Standard guidelines regarding vasopressor and inotropic support in septic shock states: "Either norepinephrine or dopamine (through a central catheter as soon as possible) is the first-choice vasopressor agent to correct hypotension in septic shock." But overall trend is going towards using norepinephrine as the first-choice vasopressor to correct hypotension in septic shock after fluid resuscitation. In a recent study from Rush University Medical Center, Chicago, IL the safety of Dopamine (DA) versus Norepinephrine (NE) as vasopressor therapy in septic shock has been compared. Sixty-six patients, 35 DA and 31 NE, has been compared. Though there was no significant difference in mortality cardiac dysrhythmias occurred in 31.4% of the DA group compared to only 3.2% for NE (p=0.003). But important aspect of study was, all cardiac dysrhythmias required an intervention.
Related Pearls:
1. Renal Dose Norepinephrine !
2. Dopamine-S and Dopamine-R patients ?
References: Click to get article/abstract: (appears in popup window and second popup overwrites first popup).
1. Vasopressor and inotropic support in septic shock: An evidence-based review Critical Care Medicine: Volume 32(11) Supplement November 2004 pp S455-S465
2. THE SAFETY OF DOPAMINE VERSUS NOREPINEPHRINE AS VASOPRESSOR THERAPY IN SEPTIC SHOCK - chest, 2005
