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Background/Aims: Despite some evidence supporting its utility, the role of adjunctive dobutamine in the management of septic shock remains unclear.

Methods: The nationwide prospective sepsis cohort of the Korean Sepsis Alliance was analyzed. Adult patients with septic shock receiving norepinephrine were enrolled over a 29-month period. Patients given a dobutamine infusion within 3 days of intensive care unit (ICU) admission were compared with patients who received no infusion. To balance baseline characteristics, propensity score matching (PSM) was used.

Results: Of 11,981 patients with sepsis, 1,827 patients with septic shock receiving norepinephrine were included (108 dobutamine vs. 1,719 no dobutamine; mean age 71.4 ± 13.2 years, 59.4% male). After PSM (ratio of 1:2; 105 dobutamine patients and 209 no-dobutamine patients), Sequential Organ Failure Assessment scores and lactate levels on ICU day 3 did not significantly differ between groups. Additionally, in-hospital and ICU mortality rates did not differ between groups (54.3% vs. 48.3%, p = 0.319; 46.7% vs. 39.2%, p = 0.208, respectively). A Cox proportional model revealed that dobutamine use was not associated with in-hospital mortality (HR 1.13, 95% CI 0.81–1.58). However, subgroup analysis indicated that dobutamine use was associated with an increased risk of in-hospital mortality among patients in the lowest quintile of early fluid balance (p = 0.0286 for interaction).

Conclusions: Adjunctive dobutamine administration did not improve short-term organ function or hospital outcomes in septic shock patients. However, early fluid balance may influence the impact of dobutamine, highlighting the importance of a more tailored approach.

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기사명 저자명 페이지 원문 목차
Coagulopathy and platelet abnormalities in patients with inflammatory bowel disease Dae Sung Kim, Won Moon p. 866-875
Managing dyslipidemia in chronic kidney disease : a comprehensive overview of evidence and recommendations Ji Yoon Kim, Suk Min Chung, Nam Hoon Kim p. 876-889
Shared decision-making for kidney replacement therapy : a comprehensive review and a proposed model Hyun Jung Shin, Seoyoung Choi, Sejoong Kim p. 890-908
Clinical challenges and individualized approaches to dialysis therapy in older adults Sungmi Kim, Yu Ah Hong p. 909-926, [1]
Current perspectives on sarcopenia : diagnosis and therapeutic approaches Jung-Yeon Choi, Kwang-il Kim, Cheol-Ho Kim p. 927-938
Exosomal miRNA-720 as a potential diagnostic and prognostic biomarker for hepatocellular carcinoma Ji Min Kim, Hye Seon Kim, Jin Seoub Kim, Ji Won Han, Soon Kyu Lee, Heechul Nam, Pil Soo Sung, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Jeong Won Jang p. 939-951, [1-7]
Risk of colorectal cancer in kidney transplant recipients and patients with end-stage renal disease undergoing hemodialysis Yongchel Ahn, Hoon Yu, Bae Yoon-Jong, Mina Kim, Seung Bum Lee p. 952-960
Association of the triglyceride-glucose index with cardiovascular outcomes across cardiovascular-kidney-metabolic syndrome stages Byung Sik Kim, Hyun-Jin Kim, Shinje Moon, Hasung Kim, Jungkuk Lee, Jeong-Hun Shin p. 961-974, [1-17]
Long-term clinical outcome and risk stratification across stages of cardiovascular-kidney-metabolic syndrome in a nationwide cohort Hyun-Jin Kim, Byung Sik Kim, Hasung Kim, Jungkuk Lee, Ha Hye Jo, Dong Wook Kim, Jeong-Hun Shin, Ki-Chul Sung p. 975-989, [1-16]
Effects of adjunctive dobutamine on outcomes among patients with septic shock : a propensity score matching analysis Sung Yoon Lim, Kyu Jin Lee, Yeonhoon Jang, Yeon Joo Lee, Ryoung-Eun Ko, Gee Young Suh, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, Sunghoon Park p. 990-1001, [1-11]
Predictive value of the modified ROX index for extubation failure in mechanically ventilated patients Kwonhyung Hyung, Kyung-Eui Lee, Yoon Hae Ahn, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee p. 1002-1016, [1-7]
Comprehensive approaches to diabetes in the elderly : adapting to evolving trends Jeongmin Lee, Kwang Joon Kim, Yang Sun Park, Yong-ho Lee, Kyeong Hye Park, Hee-Won Jung, Bong-Soo Cha, Hun-Sung Kim, Chang Oh Kim p. 1017-1028, [1]
Real-world treatment outcomes in South Korean patients with epidermal growth factor receptor-mutant non-small cell lung cancer Young Saing Kim, Eun Young Lee, Hyun Woo Lee, Jin-Hyuk Choi, Tae-Hwan Kim, Yong Won Choi, Mi Sun Ahn p. 1029-1041
Treatment satisfaction and its determinants in Korean patients with rheumatoid arthritis and systemic lupus erythematosus Hyo Jin Choi, Mi Ryoung Seo, Eunji Kim, Han Joo Baek p. 1042-1051, [1-3]
Real-world clinical response and efficacy of tacrolimus-based maintenance therapy for Korean patients with lupus nephritis Ji-Won Kim, Ju-Yang Jung, Hyoun-Ah Kim, Chang-Hee Suh p. 1052-1064

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