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Despite many attempts to find a magic bullet for treating patients with septic shock, mortality remains high. Epinephrine has been shown to have deleterious effects on splanchnic blood flow and acid-base balance compared with norepinephrine, but these effects are transient, and whether one of these vasopressors is a better choice than the other remains unclear.
French researchers prospectively randomized 330 adult patients who were admitted to 1 of 19 intensive care units with septic shock to receive either epinephrine plus placebo or norepinephrine plus dobutamine, titrated to achieve a mean arterial pressure of at least 70 mm Hg. Baseline characteristics were similar in the two groups, except that the epinephrine plus placebo group was sli…