Norepinephrine vs. Dopamine for Septic Shock

In a nonrandomized study, investigators used complex statistical methods to reach the flawed conclusion that norepinephrine is inferior to dopamine.

Early goal-directed therapy generally is considered to be the preferred treatment for patients with septic shock. However, studies to date have not identified clearly the best choice of vasopressor for patients who do not respond to fluids. In an observational study, investigators analyzed in-hospital mortality rates among 458 consecutive adult patients with septic shock who were treated with norepinephrine (73%) or dopamine (51%) in 17 intensive care units (ICUs) in Portugal.

In-hospital mortality rates were significantly higher among patients who received norepinephrine than among those who received dopamine in the study group overall (52% vs. 38%) and in the subgroup of patients who received either agent as the sole vasopressor (47% vs. 2…

Reviewing Author

Daniel J. Pallin, MD, MPH