{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T20:18:37Z","timestamp":1785010717472,"version":"3.55.0"},"reference-count":46,"publisher":"Centre for Evaluation in Education and Science (CEON\/CEES)","issue":"2","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/BY\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Biochemistry"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>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&lt;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\u00b7min), 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&lt;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.<\/jats:p>","DOI":"10.5937\/jomb0-53853","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T08:32:43Z","timestamp":1735029163000},"page":"319-329","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic values of noradrenaline administered dose, procalcitonin (PCT) and blood lactic acid for septic shock"],"prefix":"10.5937","volume":"44","author":[{"given":"Lili","family":"Ding","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengru","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijun","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3964","reference":[{"key":"ref1","unstructured":"Cen F, Zhu T, Lin Z. The value of NGAL, CYS-C, and Strem-1 in the diagnosis and prediction of acute renal injury in SEPSIS. Acta Medica Mediterr 2021; 37(1): 99-103;"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Stanbaugh CL, Abter EI, Tompkins AL. Aeromonas veronii cellulitis, bacteremia, and sepsis in a patient with liver cirrhosis and end-stage renal disease following a minor abrasion with exposure to pond water: a case report and literature review. IDCases 2022; 30: e01631(1-3);","DOI":"10.1016\/j.idcr.2022.e01631"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Forner J, Schupp T, Weidner K, Rusnak J, Jawhar S, Dulatahu F, Br\u00fcck LM, Behnes M, Hoffmann U, Bertsch T, Kittel M, Akin I. Cardiac Troponin I Reveals Diagnostic and Prognostic Superiority to Aminoterminal Pro-B-Type Natriuretic Peptide in Sepsis and Septic Shock. J Clin Med 2022; 11(21): 6592(1-14);","DOI":"10.3390\/jcm11216592"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Wolfertz N, B\u00f6hm L, Keitel V, Hannappel O, K\u00fcmpers P, Bernhard M, Michael M. Epidemiology, management, and outcome of infection, sepsis, and septic shock in a German emergency department (EpiSEP study). Front Med (Lausanne) 2022; 9: 997992(1-14);","DOI":"10.3389\/fmed.2022.997992"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Bao J, Zha Y, Chen S, Yuan J, Qiao J, Cao L, Yang Q, Liu M, Shao M. The importance of serum LMAN2 level in septic shock and prognosis prediction in sepsis patients. Heliyon 2022; 8(11): e11409(1-6);","DOI":"10.1016\/j.heliyon.2022.e11409"},{"key":"ref6","unstructured":"Kang C, Zhang L, Tian H, Tian S, Wu T. Impact of completion rates of 3-hour and 6-hour bundle on the prognosis of septic shock patients. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2022; 34(9): 927-30;"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"DeGregoris JP, Bandong L, White T, Brennan MM. Quality Improvement to Promote Sepsis Reassessment: The Sepsis Reassessment Protocol Improvement Project (SRPIP). J Nurs Care Qual 2023; 38(2): 107-13;","DOI":"10.1097\/NCQ.0000000000000646"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Iramain R, Ortiz J, Jara A, Bogado N, Morinigo R, Cardozo L, Kissoon N. Fluid resuscitation and inotropic support in patients with septic shock treated in pediatric emergency department: an open-label trial. Cureus J Med Sci 2022; 14(10): e30029(1-8);","DOI":"10.7759\/cureus.30029"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Bagate F, Coppens A, Masi P, de Prost N, Carteaux G, Razazi K, Mekontso Dessap A. Cardiac and vascular effects of low-dose steroids during the early phase of septic shock: An echocardiographic study. Front Cardiovasc Med 2022; 9: 948231(1-10);","DOI":"10.3389\/fcvm.2022.948231"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Bosch NA, Teja B, Wunsch H, Walkey AJ. Practice patterns in the initiation of secondary vasopressors and adjunctive corticosteroids during septic shock in the United States. Ann Am Thorac Soc 2021; 18(12): 2049-57;","DOI":"10.1513\/AnnalsATS.202102-196OC"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Bitton E, Zimmerman S, Azevedo LCP, Benhamou D, Cecconi M, De Waele JJ, Lipman J, Martin-Loeches I, Pirracchio R, Scheeren TWL, Leone M, Einav S. An international survey of adherence to Surviving Sepsis Campaign Guidelines 2016 regarding fluid resuscitation and vasopressors in the initial management of septic shock. J Crit Care 2022; 68: 144-54;","DOI":"10.1016\/j.jcrc.2021.11.016"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Martin C, Viviand X, Leone M, Thirion X. Effect of norepinephrine on the outcome of septic shock. Critical Care Medicine 2000 Aug 1; 28(8): 2758-65;","DOI":"10.1097\/00003246-200008000-00012"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Yamamura H, Kawazoe Y, Miyamoto K, Yamamoto T, Ohta Y, Morimoto T. Effect of norepinephrine dosage on mortality in patients with septic shock. Journal of Intensive Care 2018 Dec; 6: 1-7;","DOI":"10.1186\/s40560-018-0280-1"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Jouffroy R, Hajjar A, Gilbert B, Tourtier JP, Bloch-Laine E, Ecollan P, Boularan J, Bounes V, Vivien B, Gueye PN. Prehospital norepinephrine administration reduces 30day mortality among septic shock patients. BMC Infectious Diseases 2022 Apr 6; 22(1): 345;","DOI":"10.1186\/s12879-022-07337-y"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Morales S, Wendel-Garcia PD, Ibarra-Estrada M, Jung C, Castro R, Retamal J, Cort\u00ednez LI, Severino N, Kiavialaitis GE, Ospina-Tasc\u00f3n G, Bakker J. The impact of norepinephrine dose reporting heterogeneity on mortality prediction in septic shock patients. Critical Care 2024 Jul 3; 28(1): 216;","DOI":"10.1186\/s13054-024-05011-0"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Zhou Y, Wu C, Ouyang L, Peng Y, Zhong D, Xiang X, Li J. Application of oXiris-continuous hemofiltration adsorption in patients with sepsis and septic shock: a single-centre experience in China. Front Public Health 2022; 10: 1012998(1-12);","DOI":"10.3389\/fpubh.2022.1012998"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Shen Y, Yu J, Zhou F, Yan J, Yang J, Guo Y, Lin L. The predictive performance of the lactate clearance rate combined with the APACHE II score in the prediction of sepsis-associated acute kidney injury in 7 days. Transl Androl Urol 2022; 11(4): 543-53;","DOI":"10.21037\/tau-22-225"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Gill A, Ackermann K, Hughes C, Lam V, Li L. Does lactate enhance the prognostic accuracy of the quick Sequential Organ Failure Assessment for adult patients with sepsis? A systematic review. BMJ Open 2022; 12(10): e060455(1-10);","DOI":"10.1136\/bmjopen-2021-060455"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Schuetz P, Maurer P, Punjabi V, Desai A, Amin DN, Gluck E. Procalcitonin decrease over 72 hours in US critical care units predicts fatal outcome in sepsis patients. Critical Care 2013 Jun; 17: 1-8;","DOI":"10.1186\/cc12787"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Annane D, Maxime V, Faller JP, Mezher C, Clec'h C, Martel P, Gonzales H, Feissel M, Cohen Y, Capellier G, Gharbi M. Procalcitonin levels to guide antibiotic therapy in adults with non-microbiologically proven apparent severe sepsis: a randomised controlled trial. BMJ open 2013 Jan 1; 3(2): e002186;","DOI":"10.1136\/bmjopen-2012-002186"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Wacker C, Prkno A, Brunkhorst FM, Schlattmann P. Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. The Lancet Infectious Diseases 2013 May 1; 13(5): 426-35;","DOI":"10.1016\/S1473-3099(12)70323-7"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Molano-Franco D, Arevalo-Rodriguez I, Muriel A, del Campo-Albendea L, Fern\u00e1ndez-Garc\u00eda S, Alvarez-M\u00e9ndez A, Simancas-Racines D, Viteri A, Sanchez G, Fernandez-Felix B, Lopez-Alcalde J. Basal procalcitonin, C-reactive protein, interleukin-6, and presepsin for prediction of mortality in critically ill septic patients: a systematic review and meta-analysis. Diagnostic and Prognostic Research 2023; 7(1), p.15;","DOI":"10.1186\/s41512-023-00152-2"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Ventura AM, Shieh HH, Bousso A, G\u00f3es PF, Iracema de C\u00e1ssia FO, de Souza DC, Paulo RLP, Chagas F, Gilio AE. Double-blind prospective randomised controlled trial of dopamine versus epinephrine as first-line vasoactive drugs in pediatric septic shock. Critical Care Medicine 2015; 43(11), pp. 2292-302;","DOI":"10.1097\/CCM.0000000000001260"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"De Backer D, Aldecoa C, Njimi H, Vincent JL. Dopamine versus norepinephrine in the treatment of septic shock: a meta-analysis. Critical Care Medicine 2012 Mar 1; 40(3): 725-30;","DOI":"10.1097\/CCM.0b013e31823778ee"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Belletti A, Benedetto U, Biondi-Zoccai G, Leggieri C, Silvani P, Angelini GD, Zangrillo A, Landoni G. The effect of vasoactive drugs on mortality in patients with severe sepsis and septic shock. A network meta-analysis of randomised trials. Journal of Critical Care 2017 Feb 1; 37: 91-8;","DOI":"10.1016\/j.jcrc.2016.08.010"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Massart N, Mansour A, Ross JT, Ecoffey C, Aninat C, Verhoye JP, Launey Y, Tadie JM, Auffret V, Flecher E, Nesseler N. Epinephrine administration in venoarterial extracorporeal membrane oxygenation patients is associated with mortality: a retrospective cohort study. ESC Heart Failure 2021 Aug; 8(4): 2899-906;","DOI":"10.1002\/ehf2.13370"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Freund Y, Lemachatti N, Krastinova E, Van Laer M, Claessens YE, Avondo A, Occelli C, Feral-Pierssens AL, Truchot J, Ortega M, Carneiro B. Prognostic accuracy of sepsis-3 criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. Jama 2017 Jan 17; 317(3): 301-8;","DOI":"10.1001\/jama.2016.20329"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Jiang J, Yang J, Mei J, Jin Y, Lu Y. Head-to-head comparison of qSOFA and SIRS criteria in predicting the mortality of infected patients in the emergency department: a meta-analysis. Scandinavian Journal of Trauma, Resusci - tation and Emergency Medicine 2018 Dec; 26: 1-1;","DOI":"10.1186\/s13049-018-0527-9"},{"key":"ref29","unstructured":"Sanguanwit P, Yuksen C, Khorana J, Sutham K, Phootothum Y, Damdin S. Development of a Clinical Score for Predicting 28-Day Mortality in Geriatric Sepsis Patients; a Cohort study. Archives of Academic Emer - gency Medicine 2024 Jun 29; 12(1): e56;"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Macdonald SP, Arendts G, Fatovich DM, Brown SG. Comparison of PIRO, SOFA, and MEDS scores for predicting mortality in emergency department patients with severe sepsis and septic shock. Academic Emergency Medicine 2014 Nov; 21(11): 1257-63;","DOI":"10.1111\/acem.12515"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Songsangjinda T, Khwannimit B. Comparison of severity score models based on different sepsis definitions to predict in-hospital mortality among sepsis patients in the Intensive Care Unit. Medicina Intensiva (English Edition) 2020 May 1; 44(4): 226-32;","DOI":"10.1016\/j.medine.2018.12.007"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Aggrawal K, Verma S, Stoltzfus MT, Singh B, Anamika FN, Jain R. Tools for Screening, Predicting, and Evaluating Sepsis and Septic Shock: A Comprehensive Review. Cureus 2024 Aug; 16(8);","DOI":"10.7759\/cureus.67137"},{"key":"ref33","unstructured":"Wang T, Cui YL, Chu ZX, Liu J, Ban Y, Li TS. Value of a model based on PIRO conception in predicting the prognosis in critical patients. Zhonghua wei Zhong Bing ji jiu yi xue. 2013 Dec 1; 25(12): 729-33;"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Zheng Y, Peng L, He Z, Zou Z, Li F, Huang C, Li W. Identification of differentially expressed genes, transcription factors, microRNAs and pathways in neutrophils of sepsis patients through bioinformatics analysis. Cell Mol Biol (Noisy-le-grand) 2022; 67(5): 405-20;","DOI":"10.14715\/cmb\/2021.67.5.53"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Zang X, Chen S, Zhang L, Zhai Y. Toxic epidermal necrolysis in hepatitis A infection with acute-on-chronic liver failure: Case report and literature review. Front Med (Lausanne) 2022; 9: 964062(1-9);","DOI":"10.3389\/fmed.2022.964062"},{"key":"ref36","unstructured":"Liang X, Wang Q, Jiang Z, Li Z, Zhang M, Yang P, Wang X, Wang Y, Qin Y, Li T, Zhang T, Wang Y, Sun J, Li Y, Luo H, Li L. Clinical research linking Traditional Chinese Medicine constitution types with diseases: a literature review of 1639 observational studies. J Tradit Chin Med 2020; 40(4): 690-702;"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Kapoor AR, Bhalavat RL, Chandra M, Pareek V, Moosa Z, Markana S, Nandakumar P, Bauskar P, Shincy NV. A randomised study for dosimetric assessment and clinical impact of bone marrow sparing intensity-modulated radiation therapy versus 3-dimensional conformal radiation therapy on hematological and gastrointestinal toxicities in cervical cancer. J Cancer Res Ther 2022; 18(6): 1490-7;","DOI":"10.4103\/jcrt.JCRT_1242_20"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Petrovic J, Turnic TN, Zivkovic V, Andjic M, Draginic N, Stojanovic A, Milinkovic I, Bolevich S, Jevdjic J, Jakov - ljevic V. Correlation of redox status with procalcitonin and C-reactive protein in septic patients. Oxid Med Cell Longev 2020; 2020: 5147364(1-10);","DOI":"10.1155\/2020\/5147364"},{"key":"ref39","unstructured":"Kanashvili B, Saganelidze K, Ratiani L. The role of procalcitonin and blood lactic acid values in prognosis of sepsis and septic shock in polytrauma patients. Georgian Med News 2018; (279): 102-7;"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Li S, Shen Y, Chang B, Wang N. Prognostic value of Albumin-to-Fibrinogen ratio for 28-Day mortality among patients with sepsis from various infection sites. Mediators Inflamm 2022; 2 022:3 578528(1-9);","DOI":"10.1155\/2022\/3578528"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Hou H, Yang J, Han Z, Zhang X, Tang X, Chen T. Predictive values of the SOFA score and procalcitonin for septic shock after percutaneous nephrolithotomy. Urolithiasis 2022; 50(6): 729-35;","DOI":"10.1007\/s00240-022-01366-7"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Colussi G, Perrotta G, Pillinini P, Dibenedetto AG, Da Porto A, Catena C, Sechi LA. Prognostic scores and early management of septic patients in the emergency department of a secondary hospital: results of a retrospective study. BMC Emerg Med 2021; 21(1): 152(1-10);","DOI":"10.1186\/s12873-021-00547-8"},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Innocenti F, Tozzi C, Donnini C, De Villa E, Conti A, Zanobetti M, Pini R. SOFA score in septic patients: incremental prognostic value over age, comorbidities, and parameters of sepsis severity. Intern Emerg Med 2018; 13(3): 405-12;","DOI":"10.1007\/s11739-017-1629-5"},{"key":"ref44","doi-asserted-by":"crossref","unstructured":"Endo A, Yamakawa K, Tagami T, Umemura Y, Takahashi K, Nagasawa H, Araki Y, Kojima M, Sera T, Yagi M, Yamamoto R, Takahashi J, Nakane M, Takeda C, Narita C, Kazuma S, Okura H, Takahashi H, Wada T, Tahara S, Matsuoka A, Masaki T, Shiraishi A, Shimoyama K, Yokokawa Y, Nakamura R, Sageshima H, Yanagida Y, Takahashi K, Otomo Y. Optimal target blood pressure in elderly with septic shock (OPTPRESS) trial: study protocol for a randomised controlled trial. Trials 2022; 23(1): 799(1-10);","DOI":"10.1186\/s13063-022-06732-9"},{"key":"ref45","doi-asserted-by":"crossref","unstructured":"Zhang JG, Fu SM, Liu F, Wan JG, Wu SB, Jiang GH, Tao WQ, Zhou W, Qian KJ. Correlation and prognostic asses - sment of low T3 syndrome and norepinephrine dosage for patients with sepsis: a retrospective single-center (cohort) study. Int J Gen Med 2022; 15: 4837-47;","DOI":"10.2147\/IJGM.S362748"},{"key":"ref46","doi-asserted-by":"crossref","unstructured":"Yu C, Fan W, Shao M. Norepinephrine dosage is associated with lactate clearance after resuscitation in patients with septic shock. Front Med (Lausanne) 2021; 8: 761656(1-7);","DOI":"10.3389\/fmed.2021.761656"}],"container-title":["Journal of Medical Biochemistry"],"original-title":["Dijagnostike vrednosti doze primenjenog noradrenalina, prokalcitonina (PCT) i krvnog laktata za septi\u010dki \u0161ok"],"language":"en","link":[{"URL":"https:\/\/aseestant.ceon.rs\/index.php\/jomb\/article\/download\/53853\/26609","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/scindeks-clanci.ceon.rs\/data\/pdf\/1452-8258\/2025\/1452-82582502319D.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T21:31:27Z","timestamp":1742592687000},"score":1,"resource":{"primary":{"URL":"https:\/\/scindeks.ceon.rs\/Article.aspx?artid=1452-82582502319D"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":46,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.5937\/jomb0-53853","relation":{},"ISSN":["1452-8258","1452-8266"],"issn-type":[{"value":"1452-8258","type":"print"},{"value":"1452-8266","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]}}}