Analysis of the application effect of dobutamine in septic shock patients
HOU Lin1, WU Xue2, SUN Ziguo3
1. Critical Care Department, Enyang District People's Hospital, Bazhong 636000, China; 2. Department of Respiratory and Critical Care Medicine, Enyang District People's Hospital, Bazhong 636000, China; 3. Critical Care Department of Bazhong Central Hospital, Bazhong 636000, China
Abstract：Objective To explore the influence of dobutamine on blood lactic acid, cardiorenal function and tissue perfusion in patients with septic shock. Methods Patients with septic shock were retrospectively analyzed in our hospital from December 2020 to December 2023. Both groups were given conventional treatment, and were divided into a conventional group and a DOB group according to different treatment plans. The conventional group received norepinephrine treatment, while the DOB group received a combination of dobutamine treatment on this basis. After propensity matching to exclude confounding factors, 51 patients with no significant differences in baseline data were obtained in each group. The changes of heart rate (HR), blood pressure (BP), mean arterial pressure (MAP) and blood lactic acid (LAC) before treatment and on the 1st day, 3rd day and 7th day of treatment, changes of cardiac function [left ventricular ejection fraction (LVEF), cardiac index (CI), global end-diastolic volume index (GEDVI) ], renal perfusion [urine volume (UV), serum creatinine (Scr) ] and renal filtration function [filtered water excretion fraction (FEH2O), filtered sodium excretion fraction (FENa) ] before treatment and on the 7th day of treatment and mortality within 28 days were compared between groups. Results There were significant differences in HR, BP, MAP and LAC from the aspects of between groups. On the 1st day, 3rd day and 7th day of treatment, HR and LAC in DOB group were significantly lower than those in conventional group, and BP and MAP were significantly higher than those in conventional group. After 7 days of treatment, LVEF, CI and GEDVI in the two groups were increased significantly, and the DOB group had significantly higher LVEF, CI and GEDVI. UV in both groups after 7 days of treatment was risen significantly while Scr was declined significantly, and UV in DOB group was significantly higher while Scr was significantly lower compared to conventional group. After 7 days of treatment, FEH2O in both groups was significantly enhanced while FENa was significantly reduced, and FEH2O in DOB group was significantly higher than that in conventional groupwhile FENa was significantly lower. The number of dead cases within 28 days and average survival time were 11 cases (21.57%) and (24.96±6.37) d in conventional group and those in DOB group were 13.73% and (27.04±3.02) d. There was no significant difference in prognosis between the two groups. Conclusion Dobutamine can effectively improve cardiac function and renal function and enhance tissue perfusion in patients with septic shock.
2024, Vol. 21 
