Pharmacologie cardiovasculaire : libre accès

Abstrait

Comparing the Use of Dopamine and Norepinephrine in Shock Treatment

Majid Jalalyazdi, Amir Reza Parvizian and Shahrzad Mohseny Abyaneh

Background: The vasopressor agents, such as norepinephrine and dopamine have been endorsed as the standard choice for shock treatment. However, there is controversy regarding the use of vasopressor agents for shock treatment. Considering the use of norepinephrine over dopamine, the present study aimed at assessing the reasons for the reduced death rate among the patients who were in shock.

Methods: Three randomized studies comprising of 62 patients were identified in a meta-analysis that made a comparison of the effects of the two agents on patients suffering from gangrenous shock. Based on the inadequacy of data, a controlled and randomized study was conducted to predict the better results after administration of norepinephrine.

Results: The patients treated with dopamine recorded more arrhythmic occasions than those administered with norepinephrine. The results indicated that norepinephrine is a prudent choice in shock treatment. Norepinephrine was also found to increase in the blood pressure after load, which reduces the cardiac output by increasing the myocardial demand of oxygen.

Conclusion: Even though the death rate did not have a major difference between the patients administered with dopamine and those with norepinephrine, the study raised serious concerns regarding the safety of dopamine therapy. This is because when compared with norepinephrine, dopamine led to more arrhythmias and higher death rate of cardiogenic shock patients.