title: [Dopamine and noradrenaline effects in the blood flux regional on therapeutic in the septic shock].
abstract: OBJECTIVE
  Norepinephrine and dopamine are used, in the state of shock, with the intention of offering hemodynamic support and to reestablish tissue perfusion. The pharmacological effects of these vasopressors can be diverse, for this reason, their use requires, through the clinician, an interpretation of the hemodynamic effects with observation of the systemic variations and region. With this in mind, the objective of this study was to analyze the publications regarding the effects of norepinephrine and low-dose dopamine in hepatosplenic perfusion and renal in treatment of septic shock.
  
  
  METHODS
  Articles were selected (n = 27) concerning the use of norepinephrine and dopamine in septic shock, published during the period of 1997 to September 2007, revised in PubMed, data base of the National Library of Medicine (NLM). The MESH method was utilized with the descriptors norepinephrine, dopamine and sepsis.
  
  
  RESULTS
  The effects of dopamine and norepinephrine in kidney perfusion are similar; there is an increase in diuresis and no change in creatinine clearance. Norepinephrine did not affect kidney tissue perfusion in spite of the increase of vascular tone. Regarding the splancnic effects, these drugs showed an increase in blood flow, though redistributing the blood in this compartment.
  
  
  CONCLUSIONS
  The best agent for the hemodynamic reestablishment that keeps the adequate regional perfusion remains inconclusive.
authors.affiliation: Hospital Universitário, USP.
authors.forename: Milena Penteado Ferraro
authors.initials: MP
authors.lastname: Miranda
authors.affiliation: Departamento de Clínica Médica, FM, USP.
authors.forename: Francisco Garcia
authors.initials: FG
authors.lastname: Soriano
authors.affiliation: Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem, USP.
authors.forename: Silvia Regina
authors.initials: SR
authors.lastname: Secoli