Comparison of efficacy of dopamine versus epinephrine infusion in fluid refractory septic shock in a tertiary care pediatric ICU.

Abstract

Objective: To compare the effectiveness of dopamine versus epinephrine as 1st line vasoactive therapy among children aged 6 months to 12 years and presenting with fluid-refractory septic shock in pediatric intensive care unit (PICU). Study Design: Randomized Controlled Trial. Setting: Department of Medicine, The Children’s Hospital, Multan, Pakistan. Period: August 2022 to January 2023. Material & Methods: A total of 156 children aged between 6 months to 12 year presenting to PICU with fluid refractory shock. Children were randomized to either Group-A (epinephrine) or Group-B (dopamine) till end points of resolution of shock was achieved. When the maximum recommended dose of the study drugs was reached, open-label vasoactive was initiated. Frequency of resolution of shock within 1st hour of resuscitation was noted. Results: In a total of 156 children, there were 85 (54.5%) children between 7 to 12 years of age. There were 90 (57.7%) males and 66 (42.3%) females. The efficacy was observed in 41 (52.6%) children in Group-A (epinephrine) versus 18 (23.1%) in Group-B (dopamine), p=0.0001. Conclusion: The epinephrine was more effective than dopamine as first-line vasoactive therapy in fluid-refractory septic shock in children aged 6 months to 12 years presenting in PICU.