Comparison of Dopamine and Norepinephrine Use for the Treatment of Hypotension in Out-Of-Hospital Cardiac Arrest Patients with Return of Spontaneous Circulation

Chao-Jui Li; Kuan-Han Wu; Chien-Chih Chen; Yat-Yin Law; Po-Chun Chuang; Yi-Chuan Chen

doi:10.1155/2020/7951025

Comparison of Dopamine and Norepinephrine Use for the Treatment of Hypotension in Out-Of-Hospital Cardiac Arrest Patients with Return of Spontaneous Circulation

Emerg Med Int. 2020 Aug 18:2020:7951025. doi: 10.1155/2020/7951025. eCollection 2020.

Authors

Chao-Jui Li¹, Kuan-Han Wu¹, Chien-Chih Chen¹, Yat-Yin Law^{2

3}, Po-Chun Chuang¹, Yi-Chuan Chen^{4

5}

Affiliations

¹ Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
² Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
³ Department of Orthopedics, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁴ Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6 W. Sec., Jiapu Rd., Puzih, Chiayi County 613, Taiwan.
⁵ Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan.

Abstract

In patients experiencing out-of-hospital cardiac arrest (OHCA), hypotension is common after return of spontaneous circulation (ROSC). Both dopamine and norepinephrine are recommended as inotropic therapeutic agents. This study aimed to determine the impact of the use of these two medications on hypotension. This is a multicenter retrospective cohort study. OHCA patients with ROSC were divided into three groups according to the post resuscitation inotropic agent used for treatment in the emergency department, namely, dopamine, norepinephrine, and dopamine and norepinephrine combined therapy. Thirty-day survival and favorable neurologic performance were analyzed among the three study groups. The 30-day survival and favorable neurologic performance rates in the three study groups were 12.5%, 13.0%, and 6.8% as well as 4.9%, 4.3%, and 1.2%, respectively. On controlling the potential confounding factors by logistic regression, there was no difference between dopamine and norepinephrine treatment in survival and neurologic performance (adjusted odds ratio (aOR): 1.0, 95% confidence interval (CI) 0.48-2.06; aOR: 0.8, 95% CI: 0.28-2.53). The dopamine and norepinephrine combined treatment group had worse outcome (aOR: 0.6, 95% CI: 0.35-1.18; aOR: 0.2, 95% CI: 0.05-0.89). In conclusion, there was no significant difference in post-ROSC hypotension treatment between dopamine and norepinephrine in 30-day survival and favorable neurologic performance rates.