Norepinephrine and Dopamine Treatment for Shock Compared

Study finds overall death rates similar, but dopamine may pose danger in cardiogenic shock
By Jeff Muise
HealthDay Reporter

WEDNESDAY, March 3 (HealthDay News) -- In patients with shock, treatment with dopamine and norepinephrine results in similar overall death rates, but dopamine causes more adverse events and may pose a safety risk for patients in cardiogenic shock, according to a study in the March 4 issue of the New England Journal of Medicine.

Daniel De Backer, M.D., of the Université Libre de Bruxelles in Belgium, and colleagues randomized 1,679 patients with shock to first-line vasopressor treatment with either dopamine or norepinephrine. The study outcomes included mortality at 28 days, number of days without organ support, and adverse events.

The researchers found that mortality in the two treatment groups at 28 days was similar: 52.5 percent in the dopamine group and 48.5 percent in the norepinephrine group. However, arrhythmic events occurred more often in the dopamine group (24.1 percent) than the norepinephrine group (12.4 percent). Also, in subgroup analysis, dopamine was associated with higher mortality at 28 days in patients with cardiogenic shock than was norepinephrine, but not in patients with septic shock or hypovolemic shock.

"In summary, although the rate of death did not differ significantly between the group of patients treated with dopamine and the group treated with norepinephrine, this study raises serious concerns about the safety of dopamine therapy, since dopamine, as compared to norepinephrine, was associated with more arrhythmias and with an increased rate of death in the subgroup of patients with cardiogenic shock," the authors write.

One study author reported receiving consulting fees from the medical device company Covidien.

Abstract
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Copyright © 2010 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles Recommended Nursing Articles

Abdominal Pain: An Approach to a Challenging Diagnosis
AACN Advanced Critical Care, July/September 2014
Free access will expire on October 13, 2014.


HIPAA Compliance Practice Tips
Professional Case Management, July/August 2014
Free access will expire on September 29, 2014.


Follow the leader: How does “followership” influence nurse burnout?
Nursing Management, August 2014
Free access will expire on September 29, 2014.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events