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Davis AL, Carcillo JA, Aneja RK, Deymann AJ, Lin JC, Nguyen TC, Okhuysen-Cawley RS, Relvas MS, Rozenfeld RA, Skippen PW, Stojadinovic BJ, Williams EA, Yeh TS, Balamuth F, Brierley J, de Caen AR, Cheifetz IM, Choong K, Conway E Jr, Cornell T, Doctor A, Dugas MA, Feldman JD, Fitzgerald JC, Flori HR, Fortenberry JD, Graciano AL, Greenwald BM, Hall MW, Han YY, Hernan LJ, Irazuzta JE, Iselin E, van der Jagt EW, Jeffries HE, Kache S, Katyal C, Kissoon NT, Kon AA, Kutko MC, MacLaren G, Maul T, Mehta R, Odetola F, Parbuoni K, Paul R, Peters MJ, Ranjit S, Reuter-Rice KE, Schnitzler EJ, Scott HF, Torres A Jr, Weingarten-Abrams J, Weiss SL, Zimmerman JJ, Zuckerberg AL. American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock. Crit Care Med 2017; 45: 1061-93.

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Article

The Effect of Dopamine versus Norepinephrine on the Outcome of Pediatric Septic Shock

1Pediatrics, Faculty of Medicine, Cairo University

2MSc Pediatrics, Cairo University


American Journal of Medical Sciences and Medicine. 2017, Vol. 5 No. 4, 79-90
DOI: 10.12691/ajmsm-5-4-3
Copyright © 2017 Science and Education Publishing

Cite this paper:
Miriam Magdy Aziz, Hala Mohammed Amin Fouad, Taher H, Abdel Rahman Emam Sayed Amin. The Effect of Dopamine versus Norepinephrine on the Outcome of Pediatric Septic Shock. American Journal of Medical Sciences and Medicine. 2017; 5(4):79-90. doi: 10.12691/ajmsm-5-4-3.

Correspondence to: Miriam  Magdy Aziz, Pediatrics, Faculty of Medicine, Cairo University. Email: miriammagdyaziz@gmail.com

Abstract

Background: Septic shock is a leading cause of mortality and morbidity among children all over the world. Vasoactive therapy must be initiated in patients who have not improved after fluid resuscitation. Aim of work: The aim of this study was to compare the effect of dopamine versus norepinephrine on the outcome of pediatric septic shock. Patients and methods: The study was a prospective observational study that was conducted on 40 children aged from 1 month to 12 years who were admitted to the emergency department. They were assigned by the treating physicians to two groups: 1) Group A: 20 patients who received dopamine (5-20 mcg/kg/min). 2) Group B: 20 patients who received norepinephrine (1-1.5 mcg/kg/min). Clinical, hemodynamic, and laboratory data were recorded and compared using appropriate statistical tests. Results: Baseline characteristics for the 40 children enrolled were nearly similar. There was a significantly higher mortality rate in the dopamine group compared with the norepinephrine one (P < 0.05). As in the dopamine group, 15 patients died out of 20 patients, while in the norepinephrine group 8 patients died out of 20 patients, (75% vs. 40%, p=0.025). Stepwise logistic regression analysis revealed that PRISM-24 (p=0.001), drug (p=0.019), and MODS (p=0.003) could independently predict the mortality in septic shock patients. Conclusions: Norepinephrine was associated with an increased response to treatment and decreased risk of death in children with septic shock as compared to dopamine. Dopamine, PRISM-24, and MODS could independently predict the mortality in children with septic shock.

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