Imperial College London

Professor Anthony Gordon

Faculty of MedicineDepartment of Surgery & Cancer

Chair in Anaesthesia and Critical Care
 
 
 
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Contact

 

+44 (0)20 3312 6328anthony.gordon

 
 
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Location

 

ICUQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Scheeren:2019:10.1186/s13613-019-0498-7,
author = {Scheeren, TWL and Bakker, J and De, Backer D and Annane, D and Asfar, P and Boerma, EC and Cecconi, M and Dubin, A and Dünser, MW and Duranteau, J and Gordon, AC and Hamzaoui, O and Hernández, G and Leone, M and Levy, B and Martin, C and Mebazaa, A and Monnet, X and Morelli, A and Payen, D and Pearse, R and Pinsky, MR and Radermacher, P and Reuter, D and Saugel, B and Sakr, Y and Singer, M and Squara, P and Vieillard-Baron, A and Vignon, P and Vistisen, ST and van, der Horst ICC and Vincent, J-L and Teboul, J-L},
doi = {10.1186/s13613-019-0498-7},
journal = {Annals of Intensive Care},
title = {Current use of vasopressors in septic shock},
url = {http://dx.doi.org/10.1186/s13613-019-0498-7},
volume = {9},
year = {2019}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - BackgroundVasopressors are commonly applied to restore and maintain blood pressure in patients with sepsis. We aimed to evaluate the current practice and therapeutic goals regarding vasopressor use in septic shock as a basis for future studies and to provide some recommendations on their use.MethodsFrom November 2016 to April 2017, an anonymous web-based survey on the use of vasoactive drugs was accessible to members of the European Society of Intensive Care Medicine (ESICM). A total of 17 questions focused on the profile of respondents, triggering factors, first choice agent, dosing, timing, targets, additional treatments, and effects of vasopressors. We investigated whether the answers complied with current guidelines. In addition, a group of 34 international ESICM experts was asked to formulate recommendations for the use of vasopressors based on 6 questions with sub-questions (total 14).ResultsA total of 839 physicians from 82 countries (65% main specialty/activity intensive care) responded. The main trigger for vasopressor use was an insufficient mean arterial pressure (MAP) response to initial fluid resuscitation (83%). The first-line vasopressor was norepinephrine (97%), targeting predominantly a MAP > 60–65 mmHg (70%), with higher targets in patients with chronic arterial hypertension (79%). The experts agreed on 10 recommendations, 9 of which were based on unanimous or strong (≥ 80%) agreement. They recommended not to delay vasopressor treatment until fluid resuscitation is completed but rather to start with norepinephrine early to achieve a target MAP of ≥ 65 mmHg.ConclusionReported vasopressor use in septic shock is compliant with contemporary guidelines. Future studies should focus on individualized treatment targets including earlier use of vasopressors.
AU - Scheeren,TWL
AU - Bakker,J
AU - De,Backer D
AU - Annane,D
AU - Asfar,P
AU - Boerma,EC
AU - Cecconi,M
AU - Dubin,A
AU - Dünser,MW
AU - Duranteau,J
AU - Gordon,AC
AU - Hamzaoui,O
AU - Hernández,G
AU - Leone,M
AU - Levy,B
AU - Martin,C
AU - Mebazaa,A
AU - Monnet,X
AU - Morelli,A
AU - Payen,D
AU - Pearse,R
AU - Pinsky,MR
AU - Radermacher,P
AU - Reuter,D
AU - Saugel,B
AU - Sakr,Y
AU - Singer,M
AU - Squara,P
AU - Vieillard-Baron,A
AU - Vignon,P
AU - Vistisen,ST
AU - van,der Horst ICC
AU - Vincent,J-L
AU - Teboul,J-L
DO - 10.1186/s13613-019-0498-7
PY - 2019///
SN - 2110-5820
TI - Current use of vasopressors in septic shock
T2 - Annals of Intensive Care
UR - http://dx.doi.org/10.1186/s13613-019-0498-7
UR - http://hdl.handle.net/10044/1/67216
VL - 9
ER -