Vasopressors and Inotropes

Mueller, Scott W.; MacLaren, Robert

doi:10.1007/978-0-85729-606-1_2

Cited by 2 publications

(2 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to the Surviving Sepsis Guidelines, vasopressors are a key intervention for hemodynamic support after proper fluid resuscitation. The goal of therapy is to target a MAP of 65 mmHg [5]. Vasopressors are indicated for a decrease of >30 mmHg from baseline systolic blood pressure or MAP <60 mmHg, as either condition results in end-organ dysfunction secondary to hypoperfusion [6-7].…”

Section: Discussionmentioning

confidence: 99%

Effects of Length of Vasopressors Infusion on Mortality

Kumar¹,

Srinivas²,

Le³

et al. 2019

Cureus

View full text Add to dashboard Cite

BackgroundThere has been a myriad of studies into the physiology of vasopressors and the survival benefit of vasopressor initiation in cases of septic shock. The aim of the Effects of Length of Vasopressors Infusion on Mortality (ELVI-Mortality) study is to observe a relationship between the length of vasopressor infusion and mortality in the intensive care unit.MethodsThis was a single-center, retrospective, matched-cohort study that collected data from Arrowhead Regional Medical Center’s electronic medical records (EMR; MediTech, MA, US) using International Classification of Diseases, Tenth Revision (ICD-10) coding and a chart reviewing the past five years. Patients were on norepinephrine, phenylephrine, or epinephrine. Two patient groups were compared. The first group encompassed those with vasopressor infusion less than 48 hours in duration, whereas the second group included those with vasopressor infusion greater than 48 hours.ResultsA total of 193 patients were diagnosed as having septic shock. Participant data were obtained for 163 patients (84.4%). Of the 106 patients who had a vasopressor duration of less than 48 hours, 32 patients (30.2%) expired. Of the 57 patients that had more than 48 hours of vasopressor infusion, 18 patients (31.6%) expired.ConclusionsThere was no statistically significant increase in mortality in patients with vasopressor infusion greater than 48 hours as compared to less than 48 hours.

show abstract

Section: Discussionmentioning

confidence: 99%

Effects of Length of Vasopressors Infusion on Mortality

Kumar¹,

Srinivas²,

Le³

et al. 2019

Cureus

View full text Add to dashboard Cite

show abstract

“…Weight-based dosing strategies for vasoactive medications have been suggested based on the drugs' pharmacokinetics. Since all inotropes and vasopressors, with the exception of milrinone, have short half-lives, fast onsets, and low volumes of distribution, the use of ideal body-weight (IBW) has been suggested for all weight-based vasoactive drugs [ 5 ]. Due to the frequent and rapid titration of these agents to a predetermined clinical effect, the lower starting dose provided by an ideal body weight-based dose seems to be a safer and reasonable strategy.…”

Section: Discussionmentioning

confidence: 99%

A Real‐World, Multicenter Assessment of Drugs Requiring Weight‐Based Calculations in Overweight, Adult Critically Ill Patients

Kane‐Gill

Wytiaz

Thompson

et al. 2013

The Scientific World Journal

View full text Add to dashboard Cite

Prescribing appropriate doses of drugs requiring weight-based dosing is challenging in overweight patients due to a lack of data. With 68% of the US population considered overweight and these patients being at an increased risk for hospitalization, clinicians need guidance on dosing weight-based drugs. The purpose of this study was to identify “real-world” dose ranges of high-risk medications administered via continuous infusion requiring weight-based dosing and determine the reasons for dosing changes (ineffectiveness or adverse drug reactions). A prospective, multicenter, observational study was conducted in four intensive care units at three institutions. A total of 857 medication orders representing 11 different high-risk medications in 173 patients were reviewed. It was noted that dosing did not increase in proportion to weight classification. Overall, 14 adverse drug reactions occurred in nine patients with more in overweight patients (9 of 14). A total of 75% of orders were discontinued due to ineffectiveness in groups with higher body mass indexes. Ineffectiveness leads to dosing adjustments resulting in the opportunity for medication errors. Also, the frequent dosing changes further demonstrate our lack of knowledge of appropriate dosing for this population. Given the medications' increased propensity to cause harm, institutions should aggressively monitor these medications in overweight patients.

show abstract

Vasopressors and Inotropes

Cited by 2 publications

References 57 publications

Effects of Length of Vasopressors Infusion on Mortality

Effects of Length of Vasopressors Infusion on Mortality

A Real‐World, Multicenter Assessment of Drugs Requiring Weight‐Based Calculations in Overweight, Adult Critically Ill Patients

Contact Info

Product

Resources

About