Norepinephrine in septic shock: renewed interest in an old drug

Vasopressors are the mainstay after fluids in the hemodynamic support of patients with septic shock. Although dopamine is commonly used in this situation, it is sometimes ineffective. Because of its potential adverse vasoconstrictive effects, norepinephrine usually has been chosen only when all other drugs have failed in septic shock. However, several recent reports have suggested a beneficial effect of norepinephrine, often in doses higher than those commonly used. Specifically, these studies in 77 patients showed that norepinephrine effectively elevates blood pressure and increases systemic vascular resistance without decreasing cardiac output. Renal function in these patients appears to be maintained. Information on oxygen transport is variable; however, the mortality from sepsis remains high at between 17 and 50 percent. Until more information becomes available, norepinephrine appears to be a useful drug in maintaining blood pressure in patients with septic shock, but higher than usual doses may be needed.

This article has been cited by other articles:

				P. C. Minneci, K. J. Deans, B. Hansen, C. Parent, C. Romines, D. A. Gonzales, S.-X. Ying, P. Munson, A. F. Suffredini, J. Feng, et al. A canine model of septic shock: balancing animal welfare and scientific relevance Am J Physiol Heart Circ Physiol, October 1, 2007; 293(4): H2487 - H2500. [Abstract] [Full Text] [PDF]

				J. Albanese, M. Leone, F. Garnier, A. Bourgoin, F. Antonini, and C. Martin Renal Effects of Norepinephrine in Septic and Nonseptic Patients Chest, August 1, 2004; 126(2): 534 - 539. [Abstract] [Full Text] [PDF]