Why the study?
Does l-norepinephrine improve recovery rate compared to phenylephrine in patients with severe shock accompanying myocardial infarction?
Does l-norepinephrine improve recovery rate compared to phenylephrine in patients with severe shock accompanying myocardial infarction?
l-norepinephrine improves recovery in cardiogenic shock post-myocardial infarction by increasing heart contractile force, an effect not seen with phenylephrine.
Answers are grounded in this paper and cite their sources.
May support l-norepinephrine in post-MI shock; hypothesis-generating and leaves open randomized confirmation versus phenylephrine.
The treatment of 14 patients in severe shock accompanying myocardial infarction with l -norepinephrine (Levophed) in some cases and phenylephrine (Neo-Synephrine) in others demonstrated a significantly higher recovery rate with l -norepinephrine. Twelve of the patients were in congestive heart failure. Using strain-gage technics in fully conscious, trained dogs, l -norepinephrine was shown to produce substantial increments in heart contractile force in addition to its recognized pressor effects. Approximately equipressor doses of Neo-Synephrine under the same conditions had little effect on contractile force. These pronounced differences in heart force effects are presented as a basis for the difference in clinical results.
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Gazes et al. (1953) studied this question.
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