Norepinephrine
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Lack of efficacy: 3 case reports In a case series of 8 patients, 3 men aged 51–84 years were described, who exhibited lack of efficacy during treatment with norepinephrine for shock. The men, who were diagnosed with severe COVID-19 with secondary haemophagocytic lymphohistocytosis (sHLH), required admission to a intensive care unit of a hospital in Greece. Upon admission, all the three men received off-label treatment with IV anakinra 200mg 8 hourly for 7 days for the COVID-19, and also for the underlying sHLH. All the men also received off-label treatment with hydroxychloroquine, antibiotics therapy with meropenem, teicoplanin and azithromycin for the COVID-19. Two of these men also received off-label treatment with IV hydrocortisone 50mg 6 hourly for 7 days for the COVID-19. All the three men required mechanical ventilation during the hospital course. All the three men eventually developed shock [aetiology of shock not stated]. All the three men received norepinephrine at 0.13–1.11 µg/kg/min [routes not stated] for the shock. On day 7, the dose of norepinephrine was reported to be 0.08–0.59 µg/kg/min. However, the shock was found to be refractory to norepinephrine. All the men eventually died on day 9–19 due to the refractory shock. Dimopoulos G, et al. Favorable Anakinra Responses in Severe Covid-19 Patients with Secondary Hemophagocytic Lymphohistiocytosis. Cell Host & Microbe 28: 117-123, 803514889 No. 1, 8 Jul 2020. Available from: URL: http://doi.org/10.1016/j.chom.2020.05.007
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Reactions 14 Nov 2020 No. 1830
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