Dopamine and Norepinephrine Increase Venous Return by Stimulating α and β Adrenoceptors in the Dog

Maanen, E. F. Van; Banning, Jon W.; Roebel, Lawrence E.

doi:10.1097/00005344-198806000-00001

Cited by 8 publications

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“…These effects have already been demonstrated in several studies. These authors have demonstrated the effects of norepinephrine on venous return and CI by using higher dose of norepinephrine than in the present study (7)(8)(9)11). In view of the literature and our findings, we can hypothesize that the effects of norepinephrine on venous return and cardiac preload may related to higher doses and/or dose adjustments of norepinephrine.…”

Section: Discussionsupporting

confidence: 62%

“…In addition, the effects of norepinephrine on venous return and cardiac preload may be related to high doses and/or dose adjustments of norepinephrine. The mean norepinephrine dose adjustments required to demonstrate such effects was found to be higher in studies on norepinephrine weaning ( 7 – 9 , 11 ). In our study, the dynamic/static preload indices did not change with small decreases in norepinephrine.…”

Section: Discussionmentioning

confidence: 95%

“…Norepinephrine weaning is an important part of the therapeutic process when treating patients with septic shock (2,4). Because norepinephrine acts on both alpha-and beta-adrenergic receptors, it modulates several components of the cardiovascular equilibrium: venous return, cardiac preload, inotropy, and arterial load (5)(6)(7)(8)(9)(10). Because of these effects, an intuitive but uncertain corollary would be that decreasing norepinephrine decreases venous return and cardiac preload, and thus cardiac output (9,11).…”

Section: Introductionmentioning

confidence: 99%

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Arterial Hypotension Following Norepinephrine Decrease in Septic Shock Patients Is Not Related to Preload Dependence: A Prospective, Observational Cohort Study

et al. 2022

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BackgroundThe optimal management of hypotensive patients during norepinephrine weaning is unclear. The primary study aim was to assess the ability of preload dependence to predict hypotension following norepinephrine weaning. The secondary aims were to describe the effect of norepinephrine weaning on preload dependence, and the cardiovascular effects of fluid expansion in hypotensive patients following norepinephrine weaning.Materials and MethodsThis was a prospective observational monocentric study. We included PiCCO®-monitored patients with norepinephrine-treated septic shock, for whom the physician decided to decrease the norepinephrine dosage during the de-escalation phase. Three consecutive steps were evaluated with hemodynamic measurements: baseline, after norepinephrine decrease, and after 500 mL fluid expansion.ResultsForty-five patients were included. Preload dependence assessed by stroke volume changes following passive leg raising was not predictive of pressure response to norepinephrine weaning [AUC of 0.42 (95%CI: 0.25–0.59, p = 0.395)]. After fluid expansion, there was no difference in the prior preload dependence between pressure-responders and non-pressure-responders (14 vs. 13%, p = 1). The pressure response to norepinephrine decrease was not associated with pressure response after fluid expansion (40 vs. 23%, p = 0.211).ConclusionHypotension following norepinephrine decrease was not predicted by preload dependence, and there was no association between arterial hypotension after norepinephrine decrease and fluid response.

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Section: Discussionsupporting

confidence: 62%