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Prognostic value of dobutamine stress test in patients with septic shock
1Department of Critical Care Medicine, Zhong Da Hospital, Southeast University, Nanjing 210009, China. Haiboq@hotmail.com
Aim:
To evaluate the prognostic effect of dobutamine stress test in patients with septic shock.
Methods:
Patients with septic shock received intravenous infusion of dobutamine at 10 microg . kg-1 . min-1 for 1 h. Hemodynamics and oxygen metabolism was observed. A patient who was able to increase oxygen consumption index (VO2) by >15 % was designated as a responder to the test.
Results:
In 47 patients with septic shock, twenty one responders and twenty six nonresponders were identified, and mortality was 33.3 % and 76.9 % respectively. After the dobutamine infusion, the responders showed increases in cardiac index (18.1 %), oxygen delivery index (12.7 %), VO2 (38.6 %), and oxygen extraction ratio (18.0 %), and reductions in systemic vascular resistance index (18.5 %). The nonresponders demonstrated increases in cardiac index (11.5 %), but no change in oxygen delivery, VO2, and oxygen extraction ratio.
Conclusion:
Dobutamine stress test might be a good predictor of outcome in patients with septic shock.