METHODS
In this multicenter, randomized trial, we assigned patients with shock to receive
either dopamine or norepinephrine as first-line vasopressor therapy to restore and
maintain blood pressure. When blood pressure could not be maintained with a dose
of 20 μg per kilogram of body weight per minute for dopamine or a dose of 0.19 μg
per kilogram per minute for norepinephrine, open-label norepinephrine, epinephrine,
or vasopressin could be added. The primary outcome was the rate of death at
28 days after randomization; secondary end points included the number of days
without need for organ support and the occurrence of adverse events.
RESULTS
The trial included 1679 patients, of whom 858 were assigned to dopamine