Dopexamine and norepinephrine versus epinephrine on gastric perfusion in patients with septic shock: a randomized study [NCT00134212

Critical Care : the Official Journal of the Critical Care Forum
Philippe SeguinEric Bellissant

Abstract

Microcirculatory blood flow, and notably gut perfusion, is important in the development of multiple organ failure in septic shock. We compared the effects of dopexamine and norepinephrine (noradrenaline) with those of epinephrine (adrenaline) on gastric mucosal blood flow (GMBF) in patients with septic shock. The effects of these drugs on oxidative stress were also assessed. This was a prospective randomized study performed in a surgical intensive care unit among adults fulfilling usual criteria for septic shock. Systemic and pulmonary hemodynamics, GMBF (laser-Doppler) and malondialdehyde were assessed just before catecholamine infusion (T0), as soon as mean arterial pressure (MAP) reached 70 to 80 mmHg (T1), and 2 hours (T2) and 6 hours (T3) after T1. Drugs were titrated from 0.2 microg kg(-1) min(-1) with 0.2 microg kg(-1) min(-1) increments every 3 minutes for epinephrine and norepinephrine, and from 0.5 microg kg(-1) min(-1) with 0.5 microg kg(-1) min(-1) increments every 3 minutes for dopexamine. Twenty-two patients were included (10 receiving epinephrine, 12 receiving dopexamine-norepinephrine). There was no significant difference between groups on MAP at T0, T1, T2, and T3. Heart rate and cardiac output increased signif...Continue Reading

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Citations

Mar 28, 2006·Critical Care : the Official Journal of the Critical Care Forum·Andreas Meier-Hellmann
Aug 9, 2006·Critical Care : the Official Journal of the Critical Care Forum·Jurgen BirnbaumChristian Lehmann
Sep 19, 2012·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Khaled M Mahmoud, Amany S Ammar
Apr 24, 2008·Critical Care Medicine·Caroline AninatAndré Guillouzo
Nov 7, 2009·Critical Care Clinics·Steven M Hollenberg
Dec 29, 2012·JPEN. Journal of Parenteral and Enteral Nutrition·Erin E Mancl, Katie M Muzevich
Apr 9, 2019·The Annals of Pharmacotherapy·Bryan E MenichDrayton A Hammond
Feb 8, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Stefan Herget-RosenthalLakhmir S Chawla
May 16, 2019·Critical Care : the Official Journal of the Critical Care Forum·Lu ChengJun Lu
Nov 26, 2010·American Journal of Respiratory and Critical Care Medicine·Steven M Hollenberg
Feb 15, 2011·Critical Care Nursing Clinics of North America·Steven M Hollenberg

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