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Feature ArticlesDoes dopamine administration in shock influence outcome?Results of the Sepsis Occurrence in Acutely Ill Patients (SOAP)Study*Yasser Sakr, MB, BCh, MSc; Konrad Reinhart, MD, PhD; Jean-Louis Vincent, MD, PhD, FCCP;Charles L. Sprung, MD; Rui Moreno, MD, PhD; V. Marco Ranieri, MD; Daniel De Backer, MD, PhD;Didier Payen, MDThe optimal adrenergic supportin shock is controversial. Do-pamine and norepinephrineare the most commonly usedagents to restore tissue perfusion pres-sure in these conditions. Although dopa-mine is the natural precursor of norepi-nephrine, and both combine - and -adrenergic properties, they are differ-ent molecules and have different pharma-cologic profiles. Dopamine has relativelystronger 1-adrenergic properties, thusincreasing myocardial contractility morethan norepinephrine , which has rela-tively stronger -adrenergic propertiesand thus increases arterial pressure andsystemic vascular resistance more have their advantages and poten-tial disadvantages, although many of thesuggested effects of vasopressors have notbeen demonstrated in humans, particu-larly in those with critical illness.

organ perfusion. However, the combina-tion of norepinephrine with dobutamine may counteract this effect (8). In a large cohort of European inten-

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