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Variability in Vasoactive Medication use Across Pediatric Intensive Care Units: A PICU Data Collaborative Study,
Stephanie R Brown1, Julia A Heneghan2, Colleen Badke3
1Department of Pediatrics (Critical Care Medicine), Emory University School of Medicine, Atlanta, GA, US.
Journal of Intensive Care Medicine
|June 13, 2026
Summary
Vasoactive infusion use varies significantly across pediatric and cardiac intensive care units. This study highlights practice differences in medication selection and frequency, underscoring the need for outcome-based research.
Area of Science:
- Pediatric critical care medicine
- Clinical pharmacology
- Healthcare quality and safety
Background:
- Vasoactive medication use is prevalent in pediatric intensive care units (PICUs).
- Limited evidence exists to guide vasoactive medication selection, potentially leading to practice variations.
- Understanding current prescribing patterns is crucial for improving patient care.
Purpose of the Study:
- To describe the utilization patterns of vasoactive infusions across different pediatric intensive care units (PICUs) and cardiac intensive care units (CICUs).
- To identify variations in the frequency and type of vasoactive medications administered.
- To establish a baseline for future research on the impact of practice variability.
Main Methods:
- Retrospective cohort study utilizing the multi-institutional Pediatric PICU Data Collaborative (PDC) database.
- Inclusion criteria: Patients admitted to participating PICUs or CICUs between 2010 and 2022 who received vasoactive infusions within 7 days of admission.
- Data analysis focused on frequency of use, types of medications, and differences between ICU types and sites.
Main Results:
- Vasoactive infusions were administered in 22% of 75,953 ICU encounters.
- Cardiac ICU (CICU) encounters represented 20% of all encounters but accounted for 60% of vasoactive infusion use.
- Milrinone (63%) and epinephrine (59%) were the most common agents, with statistically significant site-specific variations in use (P < 0.001).
Conclusions:
- Significant variability exists in the frequency and selection of vasoactive infusion medications between different intensive care unit (ICU) sites and types (PICU vs. CICU).
- Further research is warranted to investigate the clinical impact of this observed practice variability on patient outcomes.
- The findings emphasize the need for evidence-based guidelines to standardize care and optimize vasoactive medication management.
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