How is norepinephrine used in intensive care? A field study
Sylvie Blazejewski1, Nathalie Raymond, Rajaa Lagnaoui
1CHU de Bordeaux, Bordeaux, France-INSERM U657, Bordeaux, France.
Objective:
To assess how norepinephrine (NE), an emergency treatment of cardiovascular collapse, is used in intensive care.
Methods:
Nurses and physicians of 14 intensive care units of the Bordeaux University Hospital were given questionnaires on the way they say they use NE and on actual NE treatment of patients.
Results:
The clinical monitoring parameters cited were blood pressure, heart rate and hourly urine flow. Only 25% of the prescribers indicated the systematic use of hemodynamic monitoring. All the prescribers indicated they adapted the treatment to clinical objectives and blood pressure, and 77.5% to hourly urine flow. Initial NE concentrations ranged from 0.5 to 2 mg/ml, diluted in saline or dextrose. Initial prescribed dose ranged from 0.1 to 1 microg/kg/min. Large differences were observed between services and even within units.
Conclusion:
These data clearly show the need for recommendations regarding the use of norepinephrine.
Related Concept Videos
01:30Adrenergic Agonists: Therapeutic Uses
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:26Acute Coronary Syndrome V: Nursing Management
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies