DOI: https://doi.org/10.14710/jai.v0i0.67835

COMPARISON OF THE EFFICACY OF INTRAVENOUS NOREPINEPHRINE AND PHENYLEPHRINE AS VASOPRESSOR AGENTS IN THE MANAGEMENT OF SEPTIC SHOCK IN ICU PATIENTS AT HAJI ADAM MALIK GENERAL HOSPITAL USING LACTATE AND STROKE VOLUME VARIATION INDICATORS

1Resident in Medical Education Program, Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, Indonesia

2Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, Indonesia

3Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, Indonesia

Received: 31 Oct 2024; Revised: 6 Sep 2025; Accepted: 4 Oct 2025; Available online: 13 Nov 2025.
Open Access Copyright 2025 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

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Abstract

Background: Septic shock is a critical condition requiring intensive management, including vasopressor support to maintain organ perfusion. Norepinephrine and phenylephrine are two commonly used vasopressors, but their relative effectiveness in the context of septic shock remains a subject of debate. This study aims to compare the effectiveness of intravenous norepinephrine and phenylephrine as vasopressor agents in the management of septic shock in ICU patients at Haji Adam Malik General Hospital, using lactate levels and stroke volume variation (SVV) as indicators.

Methods: This study was conducted as a randomized controlled trial (RCT). The subjects were ICU patients at Haji Adam Malik General Hospital diagnosed with septic shock and receiving either norepinephrine or phenylephrine as a vasopressor. Evaluations were conducted to monitor changes in lactate levels and SVV at therapy initiation and at specific intervals throughout the treatment period. Data were analyzed using appropriate statistical methods to compare the effects of the two vasopressors.

Results: This study included 32 samples divided into two groups: a norepinephrine group and a phenylephrine group, each consisting of 16 patients. After 6 hours of norepinephrine administration, lactate levels significantly decreased from 8.41±1.88 mmol/L to 5.76±1.99 mmol/L. There was also a significant reduction in SVV, from 14.25±2.17 mmHg to 8.18±1.90 mmHg, with statistically significant results (p<0.001). After 6 hours of phenylephrine administration, lactate levels decreased from 7.40±1.77 mmol/L to 6.70±1.77 mmol/L, and SVV decreased from 15.93±2.56 mmHg to 12.50±2.63 mmHg, also showing statistically significant results (p<0.001).

Conclusions: travenous norepinephrine is more effective than phenylephrine in reducing lactate levels and improving stroke volume variation in ICU patients with septic shock. These findings support the use of norepinephrine as the primary vasopressor in the management of septic shock, although phenylephrine may still be considered as an alternative with close monitoring of hemodynamic parameters. Further studies are needed to confirm these findings and to explore the mechanisms underlying the differences in efficacy.

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Perbandingan Efektivitas Obat Norepinephrine dan Phenylephrine Intravena Sebagai Vasopressor Pilihan dalam Tatalaksana Syok Sepsis pada Pasien ICU RSUP Haji Adam Malik dengan Indikator Asam Laktat dan Stroke Volume Variation
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Keywords: Septic shock; Norepinephrine; Phenylephrine; Lactate levels; Stroke Volume Variation

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Language : EN
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