The International Sepsis Forum's controversies in sepsis: my initial vasopressor agent in septic shock is dopamine rather than norepinephrine

Crit Care. 2003 Feb;7(1):6-8. doi: 10.1186/cc1851. Epub 2002 Dec 9.

Abstract

Norepinephrine (noradrenaline) and dopamine are commonly used first-line vasopressor agents in the treatment of patients with septic shock. Recently increasing interest has focused on whether one or other of these agents is superior in terms of improving outcome. Studies have looked particularly at the possible local effects of the vasopressors on splanchnic circulation, because evidence suggests that this area is important in the development and maintenance of septic shock. However, the many studies performed have yielded conflicting data and there is, as yet, little evidence to support one drug over the other in terms of their splanchnic effects. Overall, though, dopamine has many assets that make it a good first-line drug when compared with norepinephrine, and these are highlighted in the present, brief commentary.

Publication types

  • Comment
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiac Output / drug effects
  • Cerebrovascular Circulation / drug effects
  • Dopamine / pharmacology*
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Hypothalamo-Hypophyseal System / drug effects
  • Lactic Acid / blood
  • Norepinephrine / pharmacology*
  • Pituitary-Adrenal System / drug effects
  • Shock, Septic / drug therapy*
  • Splanchnic Circulation / drug effects
  • Tachycardia / chemically induced
  • Treatment Outcome
  • Vasoconstrictor Agents / pharmacology*

Substances

  • Vasoconstrictor Agents
  • Lactic Acid
  • Dopamine
  • Norepinephrine