S01E16 Dopamine vs Norepinephrine in Shock: SOAP II — A Historical Deep Dive

In this episode of PRISM Rounds, we revisit the landmark SOAP II randomized trial (New England Journal of Medicine, 2010) at the request of medical students who wanted the “how we got here” story behind modern vasopressor choices. We walk through the trial design and results in 1,679 ICU patients with shock, comparing dopamine vs norepinephrine as first-line vasopressor therapy, then layer in the accompanying NEJM editorial’s critique and clinical framing. We focus on what the data support, what remains inference, and why this study became so practice-shaping—especially around adverse events and bedside tradeoffs. Educational discussion only; not medical advice.Sources: https://www.nejm.org/doi/full/10.1056/NEJMoa0907118https://pubmed.ncbi.nlm.nih.gov/20200382/https://pubmed.ncbi.nlm.nih.gov/20200389/Tags#CriticalCare #ICU #Shock #SepticShock #CardiogenicShock #Vasopressors #Norepinephrine #Dopamine #Arrhythmia #Hemodynamics #RandomizedTrial #NEJM #JournalClub #EvidenceBasedMedicine #MedicalEducation #MedicalHistory #MedEd #Sepsis #Cardiology #FOAMed #SOAP-II #MedicalHistory