Journal of Medical Biochemistry (Jan 2025)

Diagnostic values of noradrenaline administered dose, procalcitonin (PCT) and blood lactic acid for septic shock

  • Ding Lili,
  • Liu Mengru,
  • Sun Haijun

DOI
https://doi.org/10.5937/jomb0-53853
Journal volume & issue
Vol. 44, no. 2
pp. 319 – 329

Abstract

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Background: Sepsis/septic shock is a life-threatening condition that requires prompt and effective treatment. Noradrenaline is a widely used vasopressor to manage septic shock, but its optimal dosage remains unclear. This study aimed to investigate the effects of noradrenaline doses on the prognosis of patients with sepsis/septic shock and identify the influencing factors for patient survival. Methods: A retrospective study was conducted on 126 patients with sepsis/septic shock who received noradrenaline treatment in the intensive care unit (ICU). Patients were divided into survival (n=91) and death (n=35) groups. Clinical data, laboratory results, and noradrenaline doses were collected and compared between the two groups. Results: The results showed that high doses of noradrenaline were associated with increased mortality. The maximum dose and cumulative dose of noradrenaline were significantly higher in the death group compared to the survival group (P<0.05). Multivariate logistic analysis identified high PCT levels, high APACHE II and SOFA scores, and high doses of noradrenaline as independent risk factors for death. Receiver operating characteristic (ROC) analysis revealed that the optimal cut-off value for the maximum dose of noradrenaline was 0.792 mg/(kg·min), with a sensitivity of 79.90% and specificity of 69.28%. KaplanMeier survival analysis showed that patients in the low-dose group had a higher survival rate and longer median survival time than those in the high-dose group (P<0.05). Conclusion: This study suggests that high doses of noradrenaline are associated with poor prognosis in patients with sepsis/septic shock. The optimal dose of noradrenaline should be carefully titrated to minimise the risk of mortality. Further studies are needed to confirm these findings and establish the optimal dosage of noradrenaline in septic shock management.

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