Belgium SOAP wants a knock out punch to Dopamine in shock !
Vaso constrictors are the mainstay drugs in the management of shock syndrome. While ,the ultimate outcome depends on the primary cause for shock, these vaso- constrictors have a critical role in sustaining life , till the organ function is recovered.
The physicians world over, differ in their choice of vasoconstrictor support .They are almost divided equally in their usage between dopamine and norepinephrine .
Surprisingly, there has been no one to one comparison trial till this study in 2010 .This trial is called SOAP 2 published from Brussels , BELGIUM .It compared the usage of these two drugs in variety of shock syndromes. It favors norepinephrine use , that includes cardiogenic shock as well.
The disadvantages of dopamine noted in this trial was
- Increased risk of arrhythmias
- Increased rate of death in cardiogenic shock
The implication of this trial may force the ACC/AHA guidelines , which advices dopamine as the first choice in shock syndromes especially in cardiogenic cause.
Dr.S.Venkatesan MD 