• Acta Pharmacol. Sin. · Jul 2002

    Randomized Controlled Trial Comparative Study Clinical Trial

    Effects of norepinephrine, epinephrine, and norepinephrine-dobutamine on systemic and gastric mucosal oxygenation in septic shock.

    • Shao-Xia Zhou, Hai-Bo Qiu, Ying-Zi Huang, Yi Yang, and Rui-Qiang Zheng.
    • Department of Critical Care Medicine, Zhong-Da Hospital and School of Clinical Medicine, Southeast University, Nanjing 210009, China.
    • Acta Pharmacol. Sin. 2002 Jul 1;23(7):654-8.

    AimTo compare the effects of dopamine, norepinephrine, epinephrine, and the combination of norepinephrine and dobutamine on systemic and gastric mucosal oxygen metabolism in patients with septic shock.MethodsSixteen patients with septic shock were enrolled in the present study. Each patient received dopamine firstly, then in a random succession epinephrine, norepinephrine, or norepinephrine-dobutamine, a mean systemic arterial pressure adjusted to >9.31 kPa. After 120 min of each treatment, hemodynamic, oxygen metabolic, and gastric mucosal parameters were obtained.ResultsEpinephrine induced a significant increase in heart rate compared with other three groups (P <0.05), and a significant higher cardiac index compared with norepinephrine alone and norepinephrine-dobutamine (P <0.05). Oxygen extraction ratio values were lower with epinephrine infusion as compared with other three groups (P <0.05). Arterial lactate concentrations decreased significantly with norepinephrine-dobutamine as compared with dopamine and epinephrine infusions (P <0.05). As compared with epinephrine infusion, the gastric intramucosal pH values were higher with norepinephrine-dobutamine infusion (7.25+/-0.09 vs 7.14+/-0.07, P <0.05).ConclusionDopamine, norepinephrine, epinephrine, or norepinephrine-dobutamine improved blood pressure. Epinephrine and dopamine had deleterious effect on oxygen metabolism, while norepinephrine plus low dose of dobutamine improved gastric mucosal perfusion and tissue oxygen utilization.

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