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Safety data favor norepinephrine over dopamine for shock
Date:3/3/2010

units added to the risk of death, and rapid heart rate is known to be a frequent side effect of dopamine, Levy notes.

Norepinephrine has been used to stabilize patients' blood pressure during cardiac and non cardiac surgery, and in intensive care units after surgery. Vasopressin, although not studied in the European clinical trial, is also a viable alternative treatment for shock, Levy says.

The hormones dopamine and norepinephrine have functions in the brain, helping neurons communicate, as well as in the body to maintain vascular tone. In an emergency situation, they both can increase blood pressure by constricting blood vessels. Dopamine is the precursor to norepinephrine in the sympathetic nervous system, and thus acts indirectly.

"The data challenge consensus guidelines that recommend dopamine as the initial vasopressor for increasing arterial pressure in the case of septic shock or cardiogenic shock," Levy writes in the editorial.

"In addition, norepinephrine needs to be considered as an initial therapeutic agent for patients in circulatory shock. The results of the study by De Backer et al should also put an end to the outdated view that the use of norepinephrine increases the risk of death."


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Contact: Lance Skelly
lskelly@emory.edu
404-686-8538
Emory University
Source:Eurekalert

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