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Impact of duration of hypotension prior to norepinephrine initiation in medical intensive care unit patients with septic shock: A prospective observational study. J Crit Care 2017 08;40:178-183 PMID: 28412642

Pubmed ID

28412642

Abstract

PURPOSE: To determine the impact of duration of hypotension prior to norepinephrine initiation on outcomes in MICU patients with septic shock. We hypothesized increased duration of hypotension prior to norepinephrine initiation would be associated with an increased risk for ICU mortality.

MATERIALS AND METHODS: We conducted a prospective-observational study in the MICU of a single-center tertiary academic medical center. We enrolled 160 adults ≥18years old with septic shock. Descriptive statistics were computed for demographic and outcome variables. Primary logistic regression analysis was adjusted for severity of illness.

RESULTS: The mean age of our patients was 59years (±17); 42% were female; the mean APACHE II score was 24.1 (±8.0), and the mean SOFA score was 9.6 (±4.0). Median duration of hypotension prior to norepinephrine initiation was 3.6h (IQR 1.6-9.9). Duration of hypotension prior to norepinephrine did not increase the risk for ICU mortality (OR 1.03 per hour after hypotension, 95% CI: 0.98-1.09, p=0.20).

CONCLUSION: Duration of hypotension less than one hour and greater than one hour prior to norepinephrine initiation in MICU patients with septic shock is not associated with an increased risk for ICU mortality.

Author List

Patel JJ, Kurman JS, Biesboer A, Taha H, Katz M, Szabo A, Simpson SQ, Jacobs ER

Authors

Elizabeth R. Jacobs MD Associate Dean, Professor in the Medicine department at Medical College of Wisconsin
Jonathan S. Kurman MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Aniko Szabo PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-85020732693

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Critical Care
Female
Humans
Hypotension
Intensive Care Units
Male
Middle Aged
Norepinephrine
Prognosis
Prospective Studies
Shock, Septic
Time Factors
Vasoconstrictor Agents
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6