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EFFECTIVENESS OF PHENYLEPHRINE VERSUS NOREPINEPHRINE FOR INITIAL HEMODYNAMIC SUPPORT OF PATIENTS WITH SEPTIC SHOCK
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Language English
Corres.Author Dr.K.Swapna Latha
Email shivasaidattu123@gmail.com
Accepted Date
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It was clear from past studies that delay treatment has shown its impact on hepatisplanchnic perfusion by phenylephrine. As compared to norepinephrine on administering phenylephrine in patients with delayed administration the levels of pronounced hepatoplanchnic vasoconstriction was increased in a study. Phenylephrine is known as selective ?1-receptor agonist which mainly constricts larger arterioles with no virtual effects on terminal arterioles. Norepinephrine has shown its effect on stimulating ?1 and ?2 receptors which was comparatively low with ?1 and ?2 receptors. Many studies suggest phenylephrine as first line drug for initial vasopressor in patients with septic shock. that there are no differences between nor epinephrine and phenyl epinephrine, in terms of hemodynamics when they are administered as a first line vasopressor agent in septic shock. Phenylephrine maintains the MAP, without impairing gastrointestinal mucosal perfusion Phenylephrine improves oxygen delivery by improving splanchnic blood flow in septic shock patients. But, these are of limited number of studies to consider for clinical use. On other hand dopamine or norepinephrine is considered as first line drug for increasing peripheral vascular resistance and also to prevent organ perfusion followed by adequate volume therapy. . Cause of septic shock was assessed in different aspects like pneumonia which was noted as 4 patients in phenylephrine group and 5 patients in norepinephrine group. Meningitis was recorded as 6 patients on phenylephrine group and 5 patients in norepinephrine group. Peritonitis was observed to be 5 patients in phenylephrine group and 5 patients in norepinephrine group. Left ventricular work index was assessed in terms of g/m2/beat was 25 ± 11 and 25 ± 8 in phenylephrine and norepinephrine groups respectively. Stroke volume index was assessed in terms of g/m2/beat as 45 ± 18 and 46 ± 13 as baseline in both the groups. And after 12 hours it was assessed to be 49 ± 19 and 50 ± 11 in phenylephrine and norepinephrine groups respectively. Cardiac troponin I in terms of ng/ml was assessed to be 1.0 ± 0.9 in phenylephrine and 0.9 ± 09 in norepinephrine. After 12 hours it was assessed to be 1.1 ± 0.9 and 1.1 ± 0.8 in phenylephrine and norepinephrine group respectively.ddd