Comparison of the Efficacy of Norepinephrine and Dopamine in the Treatment of Septic Shock / 中国药房

ABSTRACT

OBJECTIVE:To compare the clinical efficacy and safety of norepinephrine(NE)and dopamine(DE)in the treat-ment of septic shock (SS). METHODS:66 SS patients was retrospectively analyzed and randomly divided into NE group and DE group. DE group was treated with DE with the initial dose of 1 μg/kg per minute by continuous infusion in central venous 48 h, and then increased 1 μg every 2 min to maintain the arterial pressure(MAP)70-80 mm Hg per minute;NE group was treated with NE the initial dose of 0.05 μg/kg per minute by continuous infusion in central venous 48 h,and then increased 0.05 μg/ time every 2 min to maintain the MAP 70-80 mm Hg per minute. At the same time,all patients were given antibiotics,oxygen inhalation,nu-tritional support and other treatment and were given ECG monitoring. The clinic data was observed,including the hemodynamic in-dexes [heart rate(HR),cardiac output index(COI),MAP and systemic vascular resistance index(SVRI)],the tissue oxygenation indexes [lactate clearance rate (LCR) and central venous oxygen saturation (SvO2)] before and 4,8,24 and 48 h after treatment, the morality rate and incidence of adverse reactions. RESULTS:After treatment,HR and COI in NE group were significantly lower than before and DE group in different time points,SVRI was significantly higher than before and DE group,the differences were statistically significant(P0.05). LCR and SVO2(except for after 4 h treatment)in 2 groups was significantly higher than before in different time points,and NE group was higher than DE group;the difference was statistically significant(P0.05). Incidence of adverse reactions in NE group was significantly lower than DE group, the differences were statistically significant(P<0.05). CONCLUSIONS:Compared with DE,NE can effectively improve the hemo-dynamic indexes and tissue oxygenation indexes in the treatment of SS,with good safety.