Hemodynamics, fluids & transfusion
Exploration of different statistical approaches in the comparison of dopamine and norepinephrine in the treatment of shock: SOAP II
Primary result · Hierarchical endpoint (death, new RRT, new arrhythmia)Result — go to the resultWin ratio 0.79 95% CI 0.68–0.92Authors' conclusion
The harm associated with the use of dopamine for the management of shock appears to be present in both septic and cardiogenic shock patients. There was no suggestion of any subgroup in which dopamine was found to be favourable over norepinephrine.
Study context
- Population
- Patients with shock enrolled in SOAP II (62% septic, 17% cardiogenic shock)
- Participants
- 1,679 patients
- Comparison
- Dopamine vs norepinephrine for shock
- Primary endpoint
- Hierarchy of:
- Death
- New use of RRT
- New-onset arrhythmia (win-ratio)
Methodological detailswin-ratio, Bayesian reanalysis stratified by shock type, risk-based and effect-based heterogeneity of treatment effect
- Win-ratio
- Bayesian reanalysis stratified by shock type
- Risk-based and effect-based heterogeneity of treatment effect
Primary result
As reported in the abstract
Hierarchical endpoint:
- Death
- New RRT
- New arrhythmia
Win ratio
0.79
95% CI 0.68–0.92
P = 0.003
Dopamine vs Norepinephrine
WR 0.79 (95% CI 0.68–0.92); P = 0.003
Further findings
Bayesian reanalysis by shock type: probability of harm with dopamine
- Probability of harm, mortality
- 0.95
- Probability of harm, composite endpoint (mortality, new renal-replacement therapy (RRT), new arrhythmia)
- > 0.99
- Probability of harm, DAFICU28
- 0.91
- Fewer DAFICU28 with dopamine, cardiogenic shock
- 0.92
Risk-based heterogeneity in treatment effect (HTE), DAFICU28
- High probability of fewer DAFICU28 with dopamine in highest quartile of predicted mortality risk
Effect-based HTE, composite endpoint
- Absolute increase in composite endpoint when receiving dopamine where model recommended norepinephrine
- 6%
- Dopamine not recommended over norepinephrine for any combination of modifiers (age, shock type, cardiomyopathy, SOFA score)
Original publication
Exploration of different statistical approaches in the comparison of dopamine and norepinephrine in the treatment of shock: SOAP II. Crit Care. Published 10 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →