Abstract
Background: The timing and use of norepinephrine (noradrenaline) (NE) in septic shock remain a matter of controversy. Aim: To study the outcome of septic patients treated with early and exclusive NE. Setting: Tertiary Intensive Care Unit. Patients: 142 patients with septic shock. Intervention: Exclusive NE infusion within 24 hours of admission to ICU. Methods and main results: Retrospective analysis of data from a unit database identified 142 patients. Their median admission simplified acute physiology score (SAPS II) score was 46 [38, 56] with 98 (69%) receiving mechanical ventilation. Mean arterial pressure (MAP) at the start of NE infusion was 60 [58, 68] mmHg. NE infusion was started at a median of 1.3 [0.3, 5.0] h after ICU admission. Restoration and maintenance of target MAP was achieved initially in all patients and, in 61.3%, within 30 min. The median peak dose of NE was 0.28 [0.14, 0.61] μg/(kg min) and the duration of infusion was 88 [42, 175] h. SAPS II predicted mortality was 40.8%, however, only 34.5% (P=0.27) died. Among the most severely ill patients (SAPS II score >56) actual mortality was 50.0% versus 74.7% predicted (P=0.07). Conclusions: Early and exclusive use of NE in hyperdynamic septic shock achieved a stable MAP >75 mmHg in all patients. Survival compared favorably with that predicted by illness severity scores.
| Original language | English |
|---|---|
| Pages (from-to) | 249-254 |
| Number of pages | 6 |
| Journal | Resuscitation |
| Volume | 62 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Aug 2004 |
| Externally published | Yes |
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Keywords
- Blood pressure
- Catecholamines
- Catecolaminas
- Choque séptico
- Cuidados Intensivos
- Intensive care
- Lactate
- Lactato
- Norepinefrina
- Norepinephrine
- Pressão arterial
- Reanimação
- Resuscitation
- Septic shock
- Shock séptico
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Nursing(all)
Cite this
Early and exclusive use of norepinephrine in septic shock. / Morimatsu, Hiroshi; Singh, Kulgit; Uchino, Shigehiko; Bellomo, Rinaldo; Hart, Graeme.
In: Resuscitation, Vol. 62, No. 2, 08.2004, p. 249-254.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Early and exclusive use of norepinephrine in septic shock
AU - Morimatsu, Hiroshi
AU - Singh, Kulgit
AU - Uchino, Shigehiko
AU - Bellomo, Rinaldo
AU - Hart, Graeme
PY - 2004/8
Y1 - 2004/8
N2 - Background: The timing and use of norepinephrine (noradrenaline) (NE) in septic shock remain a matter of controversy. Aim: To study the outcome of septic patients treated with early and exclusive NE. Setting: Tertiary Intensive Care Unit. Patients: 142 patients with septic shock. Intervention: Exclusive NE infusion within 24 hours of admission to ICU. Methods and main results: Retrospective analysis of data from a unit database identified 142 patients. Their median admission simplified acute physiology score (SAPS II) score was 46 [38, 56] with 98 (69%) receiving mechanical ventilation. Mean arterial pressure (MAP) at the start of NE infusion was 60 [58, 68] mmHg. NE infusion was started at a median of 1.3 [0.3, 5.0] h after ICU admission. Restoration and maintenance of target MAP was achieved initially in all patients and, in 61.3%, within 30 min. The median peak dose of NE was 0.28 [0.14, 0.61] μg/(kg min) and the duration of infusion was 88 [42, 175] h. SAPS II predicted mortality was 40.8%, however, only 34.5% (P=0.27) died. Among the most severely ill patients (SAPS II score >56) actual mortality was 50.0% versus 74.7% predicted (P=0.07). Conclusions: Early and exclusive use of NE in hyperdynamic septic shock achieved a stable MAP >75 mmHg in all patients. Survival compared favorably with that predicted by illness severity scores.
AB - Background: The timing and use of norepinephrine (noradrenaline) (NE) in septic shock remain a matter of controversy. Aim: To study the outcome of septic patients treated with early and exclusive NE. Setting: Tertiary Intensive Care Unit. Patients: 142 patients with septic shock. Intervention: Exclusive NE infusion within 24 hours of admission to ICU. Methods and main results: Retrospective analysis of data from a unit database identified 142 patients. Their median admission simplified acute physiology score (SAPS II) score was 46 [38, 56] with 98 (69%) receiving mechanical ventilation. Mean arterial pressure (MAP) at the start of NE infusion was 60 [58, 68] mmHg. NE infusion was started at a median of 1.3 [0.3, 5.0] h after ICU admission. Restoration and maintenance of target MAP was achieved initially in all patients and, in 61.3%, within 30 min. The median peak dose of NE was 0.28 [0.14, 0.61] μg/(kg min) and the duration of infusion was 88 [42, 175] h. SAPS II predicted mortality was 40.8%, however, only 34.5% (P=0.27) died. Among the most severely ill patients (SAPS II score >56) actual mortality was 50.0% versus 74.7% predicted (P=0.07). Conclusions: Early and exclusive use of NE in hyperdynamic septic shock achieved a stable MAP >75 mmHg in all patients. Survival compared favorably with that predicted by illness severity scores.
KW - Blood pressure
KW - Catecholamines
KW - Catecolaminas
KW - Choque séptico
KW - Cuidados Intensivos
KW - Intensive care
KW - Lactate
KW - Lactato
KW - Norepinefrina
KW - Norepinephrine
KW - Pressão arterial
KW - Reanimação
KW - Resuscitation
KW - Septic shock
KW - Shock séptico
UR - http://www.scopus.com/inward/record.url?scp=3843056882&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=3843056882&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2004.03.016
DO - 10.1016/j.resuscitation.2004.03.016
M3 - Article
VL - 62
SP - 249
EP - 254
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
IS - 2
ER -