Noradrenaline vs Dopamine in Shock

Another nail in dopamine’s coffin? In a blinded randomised controlled trial in shocked patients1, there was no difference in mortality when dopamine was compared with noradrenaline as the initial vasopressor. However the dopamine group had a significantly higher incidence of dysrythmia. In addition, mortality was higher in the predefined┬ásubgroup of 280 patients with cardiogenic shock. The results of this European study of 1679 patients are very similar to those of a similar but open-label American trial in 252 patients published recently2.
1. Comparison of Dopamine and Norepinephrine in the Treatment of Shock
NEJM 2010;362(9):779-89
2. Efficacy and Safety of Dopamine versus Norepinephrine in the Management of Septic Shock
Shock. 2009 Oct 21. [Epub ahead of print]