The Effect of Different Vasoactive Drugs on Hemodynamics and Tissue Oxygen Metabolism in Patients with Septic Shock

Objective To observe the change of hemodynamics and tissue oxygen metabolism in patients with septic shock by dopamine(DA),norepinephrine(NE),norepinephrine combined with dobutamine(NE + DT).Methods Seventy-five patients with septic shock were randomly divided into 3 groups and were given DA,NE,NE + DT respectively.The hemodynamics [mean arterial pressure(MAP),heart rate(HR),pulmonary capillary wedge pressure(PCWP),cardiac output index(CI),systemic vascular resistance index(SVRI)] and oxygen metabolism related indicators [mixed venous oxygen saturation(SvO2),early lactate clearance rate] were detected before and after treatment.Results(1) MAP,PCWP,CI,SVRI,and SvO2 were significantly increased,while HR and blood lactate were decreased significantly in each group after treatment;(2)There was no significant difference of MAP,PCWP and SVRI in each group at the same time(P0.05);(3) The HR of DA group was notablely higher than the other two groups(P0.05)and the CI of NE + DT group was conspicuously higher than the other two groups(P0.05)at the same time;(4)The SvO2 value of NE and NE + DT groups were significantly higher than DA group(P0.01),while the lactate of the two groups were significantly lower than the DA group(P0.05);(5) The early lactate clearance rate of NE + DT group was higher than other groups.Conclusion All of the vasoactive drugs can improve hemodynamics in patients with septic shock,but norepinephrine combined with dobutamine shows the advantages to improve tissue oxygen metabolism comparing with simply using of dopamine or norepinephrine.So NE + DT may be the better choice for septic shock.