Trial reportIntensive care medicine2013
Effects of dobutamine on systemic, regional and microcirculatory perfusion parameters in septic shock: a randomized, placebo-controlled, double-blind, crossover study.
Trial report in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 80 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Goal Directed Therapy Using a Physiological Holistic View. A Multicenter Study in Latin America: The ANDROMEDA-SHOCK Study
Peripheral Perfusion Versus Lactate Targeted Fluid Resuscitation in Septic Shock: ANDROMEDA-SHOCK PHYSIOLOGY STUDY
Capillary Refill Time Response to a Rapid Fluid Challenge in Septic Shock Patients: Pathophysiological Determinants, and Relation to Changes in Systemic, Regional and Microcirculatory Blood Flow
Who cites it
80 citing papers in PubMed, 3 syntheses or guidelines pooled it, 147 citations in OpenAlex.
- ESICM guidelines on circulatory shock and hemodynamic monitoring 2025.Intensive care medicine · 2025Guideline
- Early management of adult sepsis and septic shock: Korean clinical practice guidelines.Acute and critical care · 2024Guideline
- Levosimendan versus dobutamine for sepsis-induced cardiac dysfunction: a systematic review and meta-analysis.Scientific reports · 2021Pooled it
- Anisodamine hydrobromide reduces 28-day mortality in septic shock: a randomized controlled.Frontiers in pharmacology · 2026Trial
- Effects of adjunctive milrinone versus placebo on hemodynamics in patients with septic shock: a randomized controlled trial.Annals of medicine · 2025Trial
- Development and validation of a nomogram to predict the risk of renal replacement therapy among acute kidney injury patients in intensive care unit.Clinical and experimental nephrology · 2023Trial
- Effects of Levosimendan on Cellular Metabolic Alterations in Patients With Septic Shock: A Randomized Controlled Pilot Study.Shock (Augusta, Ga.) · 2017Trial
- Levosimendan Versus Dobutamine in Myocardial Injury Patients with Septic Shock: A Randomized Controlled Trial.Medical science monitor : international medical journal of experimental and clinical research · 2016Trial
- Impact of early haemodynamic goal-directed therapy in patients undergoing emergency surgery: an open prospective, randomised trial.Journal of clinical monitoring and computing · 2016Trial
- Lung-Cardiovascular Interactions and Derangements in ARDS.Comprehensive physiology · 2026Review
- Beyond shear stress: septic microvascular failure remains a multifactorial phenomenon.Critical care (London, England) · 2026Article
- The Physiology, Pathophysiology, and Clinical Implications of Fluid Resuscitation in Critically Ill Patients.Cureus · 2026Review
- The value of proportion of perfused vessels change rate in the evaluation of early organ function deterioration in septic shock and ARDS.Frontiers in medicine · 2026Article
- Dynamics of ventriculo-arterial coupling and peripheral tissue perfusion during early resuscitation of septic shock.Annals of intensive care · 2026Article
- Effects of adjunctive dobutamine on outcomes among patients with septic shock: a propensity score matching analysis.The Korean journal of internal medicine · 2025Observational
- Rethinking adjunctive dobutamine in septic shock: time to individualize, not generalize.The Korean journal of internal medicine · 2025Article
- Sepsis-Induced Cardiomyopathy and Cardiac Arrhythmias: Pathophysiology and Implications for Novel Therapeutic Approaches.Biomedicines · 2025Review
- Oxygen-Mediated Molecular Mechanisms Involved in Intestinal Ischemia and Reperfusion Injury.International journal of molecular sciences · 2025Review
- Risk factors and predictive model for mortality in acute myocardial infarction with ventricular septal rupture at high altitudes.World journal of cardiology · 2025Article
- Levosimendan versus dobutamine in septic cardiomyopathy: a randomized clinical trial on cardiac function and safety.Frontiers in cardiovascular medicine · 2025Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe role of dobutamine during septic shock resuscitation is still controversial since most clinical studies have been uncontrolled and no physiological study has unequivocally demonstrated a beneficial effect on tissue perfusion. Our objective was to determine the potential benefits of dobutamine on hemodynamic, metabolic, peripheral, hepatosplanchnic and microcirculatory perfusion parameters during early septic shock resuscitation.
methodsWe designed a randomized, controlled, double-blind, crossover study comparing the effects of 2.5-h infusion of dobutamine (5 mcg/kg/min fixed-dose) or placebo in 20 septic shock patients with cardiac index ≥2.5 l/min/m(2) and hyperlactatemia. Primary outcome was sublingual perfused microvascular density.
resultsDespite an increasing cardiac index, heart rate and left ventricular ejection fraction, dobutamine had no effect on sublingual perfused vessel density [9.0 (7.9-10.1) vs. 9.1 n/mm (7.9-9.9); p = 0.24] or microvascular flow index [2.1 (1.8-2.5) vs. 2.1 (1.9-2.5); p = 0.73] compared to placebo. No differences between dobutamine and placebo were found for the lactate levels, mixed venous-arterial pCO2 gradient, thenar muscle oxygen saturation, capillary refill time or gastric-to-arterial pCO2 gradient. The indocyanine green plasma disappearance rate [14.4 (9.5-25.6) vs. 18.8 %/min (11.7-24.6); p = 0.03] and the recovery slope of thenar muscle oxygen saturation after a vascular occlusion test [2.1 (1.1-3.1) vs. 2.5 %/s (1.2-3.4); p = 0.01] were worse with dobutamine compared to placebo.
conclusionsDobutamine failed to improve sublingual microcirculatory, metabolic, hepatosplanchnic or peripheral perfusion parameters despite inducing a significant increase in systemic hemodynamic variables in septic shock patients without low cardiac output but with persistent hypoperfusion.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.