A practice survey on vasopressor and inotropic drug therapy in Scandinavian intensive care units

Acta Anaesthesiol Scand. 2003 Jul;47(6):693-701. doi: 10.1034/j.1399-6576.2003.00129.x.

Abstract

Background: This practice survey was performed to analyse the indications for use of vasopressor/inotropic drugs, preferred drugs and doses as well as concomitant monitoring and desired haemodynamic target values in Scandinavian ICUs. An internet-based reporting system was implemented.

Methods: A total of 223 ICUs were identified in the Scandinavian countries and invited to participate in a one-day point-prevalence study. An internet-based database was constructed and a practice survey protocol designed to identify haemodynamic monitoring, indications for vasopressor/inotropic drug-therapy, fluids used for volume loading, pretreatment circulatory state, actual and targeted haemodynamic variables. Patients were eligible for the study if on vasopressor/inotropic drug-therapy for more than 4 h.

Results: A total of 114 ICUs participated. A total of 114 adult patients matched the inclusion criteria. Sixty-seven per cent of the patients had received vasopressor/inotropic drug-treatment for >24 h and 32% received more than one drug. Arterial hypotension (92%) and oliguria (50%) were most common indications. Fluid loading prior to therapy was reported in 87% of patients. Dopamine (47%) and noradrenaline (44%) were the most commonly used drugs followed by dobutamine (24%). No other drug exceeded 6%. Non-catecholamine drugs were rarely used even in cardiac failure patients. Invasive arterial pressure was monitored in 95% of patients, pulmonary artery catheters were used in 19%. Other cardiac output monitoring techniques were used in 8.5% of the patients.

Conclusion: Dopamine and noradrenaline seem to be the most commonly used inotropic/vasopressor drugs in Scandinavia. Traditional indications for inotropic/vasopressor support as hypotension and oliguria seem to be most common. Invasive monitoring was used in almost all patients, whereas a limited use of pulmonary artery catheters was noted. The internet-based reporting system proved to be an efficient tool for data collection.

MeSH terms

  • Adult
  • Cardiotonic Agents / administration & dosage
  • Cardiotonic Agents / therapeutic use*
  • Cardiovascular Agents / administration & dosage
  • Cardiovascular Agents / therapeutic use*
  • Data Collection
  • Databases, Factual
  • Drug Utilization
  • Female
  • Fluid Therapy
  • Hemodynamics
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Internet
  • Male
  • Monitoring, Physiologic
  • Plasma Substitutes / therapeutic use
  • Scandinavian and Nordic Countries

Substances

  • Cardiotonic Agents
  • Cardiovascular Agents
  • Plasma Substitutes