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Temporal trends in the utilization of vasopressors in intensive care units: an epidemiologic study

BACKGROUND: The choice of vasopressor use in the intensive care unit (ICU) depends primarily on provider preference. This study aims to describe the rate of vasopressor utilization and the trends of each vasoactive agent usage in the ICU over the span of 7 years in a tertiary referral center. METHOD...

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Autores principales: Thongprayoon, Charat, Cheungpasitporn, Wisit, Harrison, Andrew M., Carrera, Perliveh, Srivali, Narat, Kittamongkolchai, Wonngarm, Erdogan, Aysen, Kashani, Kianoush B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859949/
https://www.ncbi.nlm.nih.gov/pubmed/27154548
http://dx.doi.org/10.1186/s40360-016-0063-z
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author Thongprayoon, Charat
Cheungpasitporn, Wisit
Harrison, Andrew M.
Carrera, Perliveh
Srivali, Narat
Kittamongkolchai, Wonngarm
Erdogan, Aysen
Kashani, Kianoush B.
author_facet Thongprayoon, Charat
Cheungpasitporn, Wisit
Harrison, Andrew M.
Carrera, Perliveh
Srivali, Narat
Kittamongkolchai, Wonngarm
Erdogan, Aysen
Kashani, Kianoush B.
author_sort Thongprayoon, Charat
collection PubMed
description BACKGROUND: The choice of vasopressor use in the intensive care unit (ICU) depends primarily on provider preference. This study aims to describe the rate of vasopressor utilization and the trends of each vasoactive agent usage in the ICU over the span of 7 years in a tertiary referral center. METHODS: All adult ICU admissions, including medical, cardiac, and surgical ICUs from January 1st, 2007 through December 31st, 2013 were included in this study. Vasopressor use was defined as the continuous intravenous administration of epinephrine, norepinephrine, phenylephrine, dopamine, or vasopressin within a given ICU day. The vasopressor utilization index (VUI) was defined as the proportion of ICU days on each vasoactive agent divided by the total ICU days with vasopressor usage. RESULTS: During the study period, 72,005 ICU admissions and 272,271 ICU days were screened. Vasopressors were used in 19,575 ICU admissions (27 %) and 59,811 ICU days (22 %). Vasopressin was used in 24,496 (41 %), epinephrine in 23,229 (39 %), norepinephrine in 20,648 (34 %), dopamine in 9449 (16 %), and phenylephrine in 7508 (13 %) ICU days. The VUI(norepinephrine) increased from 0.24 in 2007 to 0.46 in 2013 and VUI(phenylephrine) decreased from 0.20 in 2007 to 0.08 in 2013 (p < 0.001 both). For epinephrine, dopamine, and vasopressin VUI did not change over the course of study. CONCLUSION: Vasopressors were used in about one fourth of ICU admissions and about one-fifth of ICU days. Although vasopressin is the most commonly used vasopressor, the use of norepinephrine found to have an increasing trajectory. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40360-016-0063-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-48599492016-05-08 Temporal trends in the utilization of vasopressors in intensive care units: an epidemiologic study Thongprayoon, Charat Cheungpasitporn, Wisit Harrison, Andrew M. Carrera, Perliveh Srivali, Narat Kittamongkolchai, Wonngarm Erdogan, Aysen Kashani, Kianoush B. BMC Pharmacol Toxicol Research Article BACKGROUND: The choice of vasopressor use in the intensive care unit (ICU) depends primarily on provider preference. This study aims to describe the rate of vasopressor utilization and the trends of each vasoactive agent usage in the ICU over the span of 7 years in a tertiary referral center. METHODS: All adult ICU admissions, including medical, cardiac, and surgical ICUs from January 1st, 2007 through December 31st, 2013 were included in this study. Vasopressor use was defined as the continuous intravenous administration of epinephrine, norepinephrine, phenylephrine, dopamine, or vasopressin within a given ICU day. The vasopressor utilization index (VUI) was defined as the proportion of ICU days on each vasoactive agent divided by the total ICU days with vasopressor usage. RESULTS: During the study period, 72,005 ICU admissions and 272,271 ICU days were screened. Vasopressors were used in 19,575 ICU admissions (27 %) and 59,811 ICU days (22 %). Vasopressin was used in 24,496 (41 %), epinephrine in 23,229 (39 %), norepinephrine in 20,648 (34 %), dopamine in 9449 (16 %), and phenylephrine in 7508 (13 %) ICU days. The VUI(norepinephrine) increased from 0.24 in 2007 to 0.46 in 2013 and VUI(phenylephrine) decreased from 0.20 in 2007 to 0.08 in 2013 (p < 0.001 both). For epinephrine, dopamine, and vasopressin VUI did not change over the course of study. CONCLUSION: Vasopressors were used in about one fourth of ICU admissions and about one-fifth of ICU days. Although vasopressin is the most commonly used vasopressor, the use of norepinephrine found to have an increasing trajectory. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40360-016-0063-z) contains supplementary material, which is available to authorized users. BioMed Central 2016-05-07 /pmc/articles/PMC4859949/ /pubmed/27154548 http://dx.doi.org/10.1186/s40360-016-0063-z Text en © Thongprayoon et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Thongprayoon, Charat
Cheungpasitporn, Wisit
Harrison, Andrew M.
Carrera, Perliveh
Srivali, Narat
Kittamongkolchai, Wonngarm
Erdogan, Aysen
Kashani, Kianoush B.
Temporal trends in the utilization of vasopressors in intensive care units: an epidemiologic study
title Temporal trends in the utilization of vasopressors in intensive care units: an epidemiologic study
title_full Temporal trends in the utilization of vasopressors in intensive care units: an epidemiologic study
title_fullStr Temporal trends in the utilization of vasopressors in intensive care units: an epidemiologic study
title_full_unstemmed Temporal trends in the utilization of vasopressors in intensive care units: an epidemiologic study
title_short Temporal trends in the utilization of vasopressors in intensive care units: an epidemiologic study
title_sort temporal trends in the utilization of vasopressors in intensive care units: an epidemiologic study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859949/
https://www.ncbi.nlm.nih.gov/pubmed/27154548
http://dx.doi.org/10.1186/s40360-016-0063-z
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