Role of Dopamine versus Adrenaline in Neonatal Septic Shock

Neonatal septic shock, a serious condition with high morbidity and mortality, especially in resource-limited settings, is treated with vasopressors such as dopamine and adrenaline, but their comparative efficacy is debated.

This study aims to compare the efficacy and safety of dopamine versus adrenaline in managing neonatal septic shock, evaluating outcomes such as survival rates, duration of hospital stay, and need for additional interventions.

A prospective, randomized, interventional study was conducted in a Level III neonatal intensive care unit. A total of 150 neonates diagnosed with septic shock were randomly assigned to receive either dopamine or adrenaline. Outcomes such as shock improvement, survival, and other clinical parameters were monitored.

There was no significant difference in baseline characteristics such as gestational age, birth weight, sex, and place of birth between the two groups. Of the 150 neonates enrolled, shock improvement was observed in 60% of those treated with dopamine and 68% of those treated with adrenaline. Mortality was higher in the dopamine group (33.3%) compared to the adrenaline group (20.0%). Adrenaline was associated with statistically significantly better outcomes in terms of hemodynamic stability, urine output, and metabolic parameters.

The study suggests that adrenaline may offer advantages over dopamine in treating neonatal septic shock, particularly by enhancing hemodynamic stability, renal perfusion, and metabolic outcomes.