A COMPARISON OF VASOPRESSIN AND PHENYLEPHRINE IN TREATMENT OF DOPAMINE RESISTANT SEPTIC SHOCK - A RANDOMISED CONTROL TRIAL
Randomised Control Trial comparing vasopressors in septic shock.
Abstract
Background: Septic shock is associated with refractory hypotension and organ dysfunction and remains an important cause of mortality in Intensive Care Units (ICUs). Vasopressors are first-line treatment. The present study aims to compare vasopressin and phenylephrine in the management of dopamine resistant septic shock in the ICU setting.
Materials and method: The study is a prospective, open-labeled, randomized study comparing the effects of vasopressin (Group I) and phenylephrine (Group II) in the management of dopamine resistant septic shock in intensive care set up. The parameters recorded from 0 to 6 hours after persistent hypotension despite maximum dose of dopamine were: Heart Rate (beats/min), SBP (mmHg), Cardiac output (L/min), Cardiac index (L/min/m2), Stroke volume (ml), Systemic vascular resistance index (dynes/cm5/m2), Oxygen delivery index (ml O2/min/m2), Urine output ( ml ), Serum lactate (mg/dl).
Result: There was a significant difference in heart rate, systolic blood pressure, cardiac output, and cardiac index in both groups from 1 hour to 6 hrs. The oxygen delivery index had a significant rise in Group II. The serum lactate level also decreased in Group II at 6 hrs.
Conclusion: From our study, we concluded that as organ perfusion and oxygenation is more important for the treatment of septic shock and to keep the vital organs functioning rather than to increase the systemic vascular resistance and the blood pressure, phenylephrine showed a better result than vasopressin in the treatment of septic shock.
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