Data on hemodynamic variables and doses of vasoactive agents are shown in Figure 3 and Figure 4 in the Supplementary Appendix. The mean arterial pressure was similar in the two treatment groups at baseline, and it changed similarly over time, although it was slightly higher from 12 to 24 hours in the norepinephrine group. The doses of the study drug were similar in the two groups at all times. More patients in the dopamine group than in the norepinephrine group required open-label norepinephrine therapy at some point (26% vs. 20%, P<0.001), but the doses of open-label norepinephrine that were administered were similar in the two groups. The use of open-label epinephrine at any time was similar in the two groups (administered in 3.5% of patients in the dopamine group and in 2.3% of those in the norepinephrine group, P=0.10), as was the use of vasopressin (0.2% in both groups, P=0.67). Dobutamine was used more frequently in patients treated with norepinephrine, but 12 hours after randomization, the doses of dobutamine were significantly higher in patients treated with dopamine. The mean (±SD) time to the achievement of a mean arterial pressure of 65 mm Hg was similar in the two groups (6.3±5.6 hours in the dopamine group and 6.0±4.9 hours in the norepinephrine group, P=0.35). There were no major between-group differences in the total amounts of fluid given, although patients in the dopamine group received more fluids on day 1 than did patients in the norepinephrine group. Urine output was significantly higher during the first 24 hours after randomization among patients in the dopamine group than among those in the norepinephrine group, but this difference eventually disappeared, so that the fluid balance was quite similar between the two groups.
Tomorrow night, Brooklyn’s Barclays Center will host the annual NBA Slam Dunk Contest as part of the league’s All-Star Weekend. Dunking a basketball is generally reserved for seasoned athletes with the incredible vertical leap required to rise high enough to stuff a ball through a ten-foot rim. But what about the aging average Joes who grew up watching high-flying stars like Dominique Wilkins and Michael Jordan? Could they ever soar high enough to achieve the dream of every schoolyard baller in the country?
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The rate of death at 28 days in this study was close to 50%, which is to be expected in a study with very few exclusion criteria and is similar to the rate in previous observational studies.3,9,21-24 Our trial was a pragmatic study that included all patients who were treated for shock states, and therefore, it has high external validity. The study design allowed for maximal exposure to the study drug, since we included patients who had received open-label vasopressors for a maximum of 4 hours before randomization and since during the 28-day study period, the study drug was withdrawn last when patients were weaned from vasopressor therapies and was resumed first if resumption of vasopressor therapy was necessary.
Which is why, on April 1, 2014, I dedicated myself to dunking a basketball for the first time. So that I could live it, breathe it, perhaps take a crack at it with my pen. I had tossed this idea around for years, realizing with each passing birthday that my chances of success were dimming. However, on that April Fool’s Day (a coincidence) I spent three hours on the court and at the gym, with a promise to myself to return several times each week until I threw one down like Gerald Green. Or at least like Litterial Green, who played in 148 NBA games between 1992 and ’99, and who, like me, was born in the early ’70s, stands 6'1", 185 pounds and is at no risk of having dunker carved into his epitaph.
Looking for something amazing for your party? Have a one of a kind experience at Vertical Jump Park! Attractions include: 6,000 square feet of open jump trampolines, 3 basketball dunking lanes, a huge stunt bag, a jousting battle beam, 2 dodgeball courts, a incredible rock climbing wall and a amazing ninja course not to mention the best arcade in town!