Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 Oct;45(10):1377-1381.
doi: 10.1038/s41372-025-02399-7. Epub 2025 Aug 28.

Dopamine versus epinephrine for neonatal septic shock: an open labeled, randomized controlled trial

Gurarsh Singh  1 , Vikram Bhaskar  2 , Prerna Batra  1 , Piyush Gupta  1
Affiliations
Randomized Controlled Trial

Dopamine versus epinephrine for neonatal septic shock: an open labeled, randomized controlled trial

Gurarsh Singh et al. J Perinatol. 2025 Oct.

Abstract

Introduction: Septic shock is one of the most common causes of neonatal mortality. Dopamine and epinephrine are the two main drugs used in fluid refractory neonatal septic shock. However, there is lack of consensus on use of first line agent in neonates.

Study design: This randomized, open labeled, controlled trial was conducted with primary objective to compare the proportion of patients achieving reversal of shock at 60 min of starting either dopamine or epinephrine as first line inotrope in neonates with fluid refractory septic shock.

Results: More patients in the epinephrine group achieved reversal of shock than dopamine group (31 vs 25) but the difference was statistically not significant [p = 0.143, RR = 0.806 (95% CI 0.602,1.080)]. All-cause mortality was 87.5% (35/40) in the dopamine group and 85% (34/40) in the epinephrine group (34/40).

Conclusion: Dopamine and epinephrine show equivalent efficacy in reversal of shock at 60 min in neonates with septic shock.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethical approval: All methods were performed in accordance with the relevant guidelines and regulations. Ethical clearance was sought from the institutional ethics committee and the trial was registered with CTRI (CTRI/2023/03/050166). The study was performed in accordance with the Declaration of Helsinki.

References

    1. Agyeman PK, Schlapbach LJ, Giannoni E, Stocker M, Posfay-Barbe KM, Heininger U, et al. Epidemiology of blood culture-proven bacterial sepsis in children in Switzerland: a population-based cohort study. Lancet. 2017;1:124–33.
    1. Weiss, Fitzgerald SL, Pappachan JC, Wheeler J, Jaramillo-Bustamante D, Salloo JC, et al. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med. 2015;191:1147–57. - DOI - PubMed - PMC
    1. Hartman ME, Linde-Zwirble WT, Angus DC, Watson RS. Trends in the epidemiology of pediatric severe sepsis. Pediatr Crit Care Med. 2013;14:686–93. - DOI - PubMed
    1. Jaramillo-Bustamante JC, Marín-Agudelo A, Fernández-Laverde M, Bareño-Silva J. Epidemiology of sepsis in pediatric intensive care units: first Colombian multicenter study. Pediatr Crit Care Med. 2012;13:501–8. - DOI - PubMed
    1. Wolfler A, Silvani P, Musicco M, Antonelli M, Salvo I. Italian Pediatric Sepsis Study (SISPe) group. Incidence of and mortality due to sepsis, severe sepsis and septic shock in Italian Pediatric Intensive Care Units: a prospective national survey. J Intensive Care Med 2008;34:1690–7. - DOI

Publication types

LinkOut - more resources