Norepinephrine, Dopamine, and Vasopressin in Patients with Sepsis and Preexisting or Acute Heart Failure: A Retrospective Cohort Study
Dandan Zhou, Baohua Zhu, Jie Jiang, Guangquan Zhou, Suming Zhou
Department of Critical Care Medicine, Jiangsu Province Hospital of Integration of Chinese and Western Medicine, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
Med Sci Monit 2021; 27:e927716
Available online: 2020-11-19
The aim of this study was to assess the impact of norepinephrine (NE), norepinephrine plus vasopressin (NE+VAS) and dopamine in patients with sepsis and heart failure.
MATERIAL AND METHODS: Data were extracted from the Medical Information Mart for Intensive Care III database, v1.4. Adults aged >18 years in an Intensive Care Unit (ICU) who had heart failure and took vasopressors were included. The patients were divided into 3 groups: NE, NE+VAS, and dopamine. Differences in survival, treatment time, and organ function among the 3 groups were compared. Propensity score matching (PSM) was used to screen for possible prognostic differences, and regression analysis was used to further analyze and predict prognoses.
RESULTS: A total of 1864 patients were included. There were significant differences among the 3 groups in 7-, 28-, and 90-day mortality after PSM. The 5-year survival rates among the 3 groups also were significantly different (P<0.001). After Cox regression analysis, NE+VAS was an independent risk factor affecting 5-year survival (P<0.001). After multiple linear regression, dopamine was the factor related to ICU and hospital lengths of stay.
CONCLUSIONS: Compared with NE or dopamine alone, NE+VAS can reduce survival in patients with sepsis and heart failure who need vasopressors. Compared with the other 2 treatment options, dopamine can shorten ICU and hospital stays for these patients.
Keywords: Dopamine, Heart Failure, Norepinephrine, Sepsis, Vasopressins