McMaster Textbook of Internal Medicine

McMaster Textbook of Internal Medicine
Interviews
ICU & Emergencies
Dopamine in the treatment of septic shock

Dopamine in the treatment of septic shock

2018-10-05

Emilie Belley-Côté

Recorded at the 4th McMaster International Review Course in Internal Medicine (MIRCIM).

References

De Backer D, Biston P, Devriendt J, et al; SOAP II Investigators. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med. 2010 Mar 4;362(9):779-89. doi: 10.1056/NEJMoa0907118. PubMed PMID: 20200382.

Is there a place for dopamine in the treatment of septic shock?

Emilie Belley-Côté, MD: The only time I will personally use dopamine after the results of the SOAP II (Sepsis Occurrence in Acutely Ill Patients II) trial for septic shock is when patients have relative chronotropic insufficiency, so if their heart rate is too slow in relation to their septic state. If someone has septic shock with a heart rate that is 60 or 70, for example, I will use dopamine to try to bring the heart rate and cardiac output up. Otherwise, my first line is norepinephrine.

See also

First-line antibiotics in sepsis of unknown origin What are the first-line antibiotics in sepsis of unknown origin?
EMS and rheumatologic emergencies What should emergency medical services (EMS) pay special attention to in terms of rheumatologic emergencies?
PoCUS and volume status examination What is the best way to assess volume status?
Fluid resuscitation in the early management of septic shock What are the current guidelines for fluid resuscitation in the early management of patients with septic shock?
Update on the management of septic shock A lecture by Dr Waleed Alhazzani, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2017.
Suspected stroke and high blood pressure in patients transported by EMS A patient with suspected stroke transported by the emergency medical services is expected to have high blood pressure. What is the threshold value that warrants attempts to lower blood pressure by the ambulance crew?
SSC 2016. Part 1: Methodology. Principles of resuscitation Prof. Waleed Alhazzani, one of the lead authors of Surviving Sepsis Campaign guidelines, gives us an insider’s view on SSC methodology and discusses main points concerning resuscitation.
Surviving Sepsis Campaign 2016 guidelines A lecture by Prof. Andrew Rhodes delivered at the conference Challenges and Opportunities in Caring for Critically Ill in Kraków in 2016.

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