الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Septic shock, the most severe form of sepsis, accounts for about 9% of admissions to intensive care units, and its short-term mortality ranged from 40% to 60%. Early institution of vasopressor treatment counteracting vasodilation and thus relative hypovolemia may, therefore, be a rational approach to reduce fluid requirements and improve pulmonary fluid clearance in septic shock patients.
The aim of this study was to compare the effect of dopamine and norepinephrine in treatment of patients presented by septic shock as regard :-
1) Rate of success as regards hemodynamic stability.
2) Duration of treatment.
3) Mortality and morbidity rate.
The present study prospectively compared the effect of administration of noradrenaline alone, dopamine alone, and dopamine combined with noradrenaline in the management of septic shock . Thirty age and sex matched patients were randomly assigned to be allocated into one of three groups with 10 patients each. Each group was respectively treated with one of the three mentioned therapeutic protocols.
The reported predisposing factors for the development of septic shock included heart disease that is present in 20 patients (66.7 %), DM in 14 patients (46.7 %), malignancy in 7 patients (23.3 %), prolonged corticosteroid therapy in 4 patients (13.3 %), hepatic impairment in 2 patients (6.7 %) and orthopedic graft in 1 patients (3.3 %).
The suspected sources of infection in the studied cases were lung in 16 patients (53.3 %), abdomen in 7 patients (23.3 %), urinary tract in 2 patients (6.7 %) and bone in 1 patient (3.3 %) and primary septicemia in 4 patients (13.3 %).
Comparison of primary outcome measures has shown that GI (receiving norepinephrine) had better results that the other two groups in achieving the targeted CVP and MBP. However, comparison of urinary output targets among groups didn’t reveal significant differences in spite of the fact that GI remains superior to other groups. In addition, comparison of the same measures between patients who received dopamine alone and those who received dopamine and epinephrine combination didn’t reveal significant differences.