Journal article
Vasopressor administration and sepsis: a survey of Canadian intensivists.
- Lamontagne F Centre de Recherche Clinique Étienne-Le Bel and Department of Medicine, Université de Sherbrooke, Sherbrooke, Canada. Electronic address: francois.lamontagne@uherbrooke.ca.
- Cook DJ Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada.
- Adhikari NKJ Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
- Briel M Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland.
- Duffett M Department of Pediatrics, McMaster University, Hamilton, Canada.
- Kho ME Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore.
- Burns KEA Department of Critical Care, St Michael's Hospital, Toronto, Canada.
- Guyatt G Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada.
- Turgeon AF Department of Anesthesiology and Centre de recherche FRSQ du CHA, Université Laval, Québec, Canada.
- Zhou Q Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
- Meade MO Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada.
- 2011-04-02
Published in:
- Journal of critical care. - 2011
Adult
Canada
Comorbidity
Critical Care
Health Care Surveys
Humans
Hypotension
Norepinephrine
Practice Patterns, Physicians'
Shock, Septic
Vasoconstrictor Agents
English
INTRODUCTION
Patients with septic shock often receive intravenous vasopressor infusions, with little evidence available to guide their titration. We surveyed Canadian intensivists to document self-reported vasopressor titration strategies for patients with septic shock.
METHODS
We identified Canadian intensivists caring for adult patients by merging membership lists of 3 Canadian critical care associations. We invited respondents to complete a scenario-based questionnaire to understand triggers for vasopressor use, target blood pressure values, and the influence of chronic comorbidities and acute illnesses on vasopressor prescription.
RESULTS
Sixty-three percent of eligible intensivists completed our survey. Most respondents (82.6%) would frequently or always administer vasopressor therapy for isolated hypotension but not for other isolated signs of organ failure (such as elevated serum lactate or low urine output). Respondents defined low blood pressure using mean arterial pressure (83.7%) and aimed for higher values when resuscitating a patient with multiple organ failure. Chronic comorbidities and acute concurrent illnesses had variable effects on stated vasopressor prescription. Norepinephrine (94.8%) was the preferred first-line vasopressor.
CONCLUSIONS
Self-reported vasopressor use for the treatment of septic shock is relatively uniform among Canadian intensivists; however, practice is variable in patients with chronic comorbidities or acute concurrent illnesses.
Patients with septic shock often receive intravenous vasopressor infusions, with little evidence available to guide their titration. We surveyed Canadian intensivists to document self-reported vasopressor titration strategies for patients with septic shock.
METHODS
We identified Canadian intensivists caring for adult patients by merging membership lists of 3 Canadian critical care associations. We invited respondents to complete a scenario-based questionnaire to understand triggers for vasopressor use, target blood pressure values, and the influence of chronic comorbidities and acute illnesses on vasopressor prescription.
RESULTS
Sixty-three percent of eligible intensivists completed our survey. Most respondents (82.6%) would frequently or always administer vasopressor therapy for isolated hypotension but not for other isolated signs of organ failure (such as elevated serum lactate or low urine output). Respondents defined low blood pressure using mean arterial pressure (83.7%) and aimed for higher values when resuscitating a patient with multiple organ failure. Chronic comorbidities and acute concurrent illnesses had variable effects on stated vasopressor prescription. Norepinephrine (94.8%) was the preferred first-line vasopressor.
CONCLUSIONS
Self-reported vasopressor use for the treatment of septic shock is relatively uniform among Canadian intensivists; however, practice is variable in patients with chronic comorbidities or acute concurrent illnesses.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jcrc.2011.01.005
- PMID 21454040
- Persistent URL
- https://sonar.ch/global/documents/205493
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