Comparative Study of Using Norepinephrine Infusion versus Dopamine in Hemodynamically Unstable Patients at Surgical Intensive Care Unit

Article Sidebar

PDF
Published Aug 9, 2025
DOI: https://doi.org/10.18103/mra.v13i7.6720

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

Muhammad Naeem
MBBS, DA, MS (Anaesthesiology), Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Center, Peoples University of Medical and Health for Women, Shaheed Benazirabad, Sindh, Pakistan.
Muhammad Saleh Khaskheli
MBBS, FCPS (Anaesthesiology), Professor and HOD, Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Center, Peoples University of Medical and Health for Women, Shaheed Benazirabad, Sindh, Pakistan.
Rafia Tabassusm
MBBS, DA (Anaesthesiology), Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Center, Peoples University of Medical and Health for Women, Shaheed Benazirabad, Sindh, Pakistan.
Nasreen Kazi
MBBS, M. Phil, Ph.D. (Pharmacology), Professor and Chair Person department of Pharmacology, Bilawal Medical College, Jamshoro, Sindh, Pakistan
Ghullam Muhammad Phull
MBBS, Phil (Physiology)Associate Professor, Department of Physiology, Gambat Medical College, Khairpur Mirs, Sindh, Pakistan
Dr Ashique Ali Arain
MBBS, MCPS (Family Medicine), M. Phil (Pharmacology), Consultant Family Physician and Associate Professor of Pharmacology, Liaquat Institute of Medical and Health Sciences, Thatta, Sindh Pakistan.

Abstract

Objective: This study evaluated the efficacy and safety of norepinephrine infusion versus dopamine in managing hemodynamically unstable patients in the surgical intensive care unit.


Methodology: This retrospective cohort study was conducted on patients admitted during 2021 and 2022. It was conducted at Peoples Medical College Hospital, Shaheed Benzirabad, Pakistan. The study included patients with hemodynamic instability, hypotension, and impaired tissue perfusion. The standardized protocol guided the administration of norepinephrine and dopamine, with doses adjusted according to hemodynamic goals and patient response.


Results: Patient records of 399 met the study criteria after reviewing the records. Among non-operative cases, 12.28% (n=49) patients received norepinephrine, while 46.37% (n=185) received dopamine. In post-operative cases, 6.27% (n=25) patients were administered norepinephrine compared to 35.08% (n=140) who received dopamine. In norepinephrine patients, 14.01% (n=16) were on self-ventilation, and 3.26% (n=13) required mechanical ventilation post-operatively, whereas, in the dopamine group, 8.77% (n=35) patients were on self-ventilation and 26.31% (n=105) on mechanical ventilation. Non-operative norepinephrine patients showed 7.02% (n=28) self-ventilation and 4.26% (n=17) mechanical ventilation, while dopamine patients showed 23.81% (n=95) self-ventilation and 22.56% (n=90) mechanical ventilation. Antibiotic use was higher in the dopamine group (76.19%, n=304) compared to the norepinephrine group (17.29%, n=69). Mortality was lower with norepinephrine (64.89%, n=48) than with dopamine (75.1%, n=244).


Conclusion: These results suggest that norepinephrine may be more effective and safer than dopamine, supporting its use as a first-line vasopressor.

Keywords: Norepinephrine, dopamine, vasopressor therapy, mortality, mechanical ventilation, antimicrobials

Article Details

How to Cite
NAEEM, Muhammad et al. Comparative Study of Using Norepinephrine Infusion versus Dopamine in Hemodynamically Unstable Patients at Surgical Intensive Care Unit. Medical Research Archives, [S.l.], v. 13, n. 7, aug. 2025. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/6720>. Date accessed: 05 dec. 2025. doi: https://doi.org/10.18103/mra.v13i7.6720.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 13 No 7 (2025): Vol.13, Issue 7, July 2025
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Gupta S, Agrawal G, Thakur S, Gupta A, Wazir S. The effect of norepinephrine on clinical and hemodynamic parameters in neonates with shock: a retrospective cohort study. European Journal of Pediatrics. 2022;181(6):2379-87.
2. Abd el Fattah Shaban A, Elsayed RM, Mohamed SG. Comparative study between the effects of arginine-vasopressin, norepinephrine or both on hemodynamics in catecholamine resistant septic shock. 2022;41(2):219-226
3. Lazzeri C, Bonizzoli M, Guetti C, Fulceri GE, Peris A. Hemodynamic management in brain dead donors. World journal of transplantation. 2021;11(10):410.
4. Sharma K, Charaniya R, Champaneri B, Bhatia S, Sharma V, Mansuri Z, Panakkal BJ, Thakkar H, Patel K. Assessing the hemodynamic impact of various inotropes combination in patients with cardiogenic shock with Non-ST elevation myocardial infarction–the ANAPHOR study. Indian Heart Journal. 2021;73(5):572-6.
5. Ahmad S, Khurshid A, Maqsood I, Arshad MS. Comparison of efficacy of dopamine versus epinephrine infusion in fluid refractory septic shock in a tertiary care pediatric ICU. The Professional Medical Journal. 2023;30(11):1456-60.
6. Jentzer JC, Hollenberg SM. Vasopressor and inotrope therapy in cardiac critical care. Journal of Intensive Care Medicine. 2021;36(8):843-56.
7. Michelle L, Bitner BF, Pang JC, Berger MH, Haidar YM et al. Outcomes of perioperative vasopressor use for hemodynamic management of patients undergoing free flap surgery: A systematic review and meta‐analysis. Head & neck. 2023;45(3):721-32.
8. Russell JA, Gordon AC, Williams MD, Boyd JH, Walley KR, Kissoon N. Vasopressor therapy in the intensive care unit. In Seminars in respiratory and critical care medicine 2021;42(01): 059-077.
9. Grand J, Møller JE, Hassager C, Schmidt H, Mølstrøm S, Boesgaard S, Meyer MA, Josiassen J, Højgaard HF, Frydland M, Dahl JS. Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest. Resuscitation. 2024;1;194:110094.
10. Berends AM, Kerstens MN, Lenders JW, Timmers HJ. Approach to the patient: perioperative management of the patient with pheochromocytoma or sympathetic paraganglioma. The Journal of Clinical Endocrinology & Metabolism. 2020;105(9):3088-102.
11. Fabick AC, Hawn JM, Barwick KW, Weeda ER, Goodwin AJ, Bell CM. Comparison of extravasation events related to the peripheral administration of vasopressors prior to and following implementation of an institutional protocol. Journal of the American College of Clinical Pharmacy. 2023 ;6(7):709-17.
12. Fabick AC, Hawn JM, Barwick KW, Weeda ER, Goodwin AJ, Bell CM. Comparison of extravasation events related to the peripheral administration of vasopressors prior to and following implementation of an institutional protocol. Journal of the American College of Clinical Pharmacy. 2023 ;6(7):709-17.
13. De Backer, D., Biston, P., Devriendt, J., et al. Comparison of dopamine and norepinephrine in the treatment of shock. New England Journal of Medicine, 2010;362(9): 779-789.
14. Schmidt, G. A., Girard, T. D., Kress, J. P., et al. Official executive summary of an American Thoracic Society/American College of Chest Physicians clinical practice guideline: liberation from mechanical ventilation in critically ill adults. American Journal of Respiratory and Critical Care Medicine,2015; 191(1): 10-20.
15. Kollef, M. H., Sherman, G., Ward, S., et al. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest,2008; 133(2): 483-494.
16. Holmes, C. L., & Walley, K. R. Bad medicine: low-dose dopamine in the ICU. Chest,2013; 143(5): 1145-1150.
17. Rhodes, A., Evans, L. E., Alhazzani, W., et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Critical Care Medicine, 2016;45(3): 486-552.
18. Vincent, J. L., De Backer, D., & Wiedermann, C. J. Fluid management in sepsis: The potential beneficial effects of albumin. Journal of Critical Care, 2018;43: 211-217.
19. Bassetti, M., Poulakou, G., & Ruppe, E. Antimicrobial resistance in the next 30 years, humankind, bugs and drugs: A visionary approach. Intensive Care Medicine,2018; 44(10): 1464-1475.
20. Peake, S. L., Delaney, A., Bailey, M., et al. Goal-directed resuscitation for patients with early septic shock. New England Journal of Medicine, 2014;371(16): 1496-1506.