Impact of noradrenaline infusion set on mean arterial pressure: a retrospective clinical study

Ann Fr Anesth Reanim. 2013 Nov;32(11):e159-62. doi: 10.1016/j.annfar.2013.08.011. Epub 2013 Oct 16.

Abstract

Objectives: Noradrenaline (NA) can be infused through various systems including single or double syringe pumps. The aim of this study was to define the best and most efficient infusion system in an emergency context.

Study design: This was a retrospective clinical study based on the analysis of patients' hemodynamic data.

Patients and method: Three infusion lines used presently in our postoperative ICU were compared through a retrospective clinical study: an NA syringe pump at 2mL/h and a saline carrier solution syringe pump at 8mL/h (infusion system 1- IS1) or 5mL/h (IS2), both connected to a very low dead-space volume set (V=0.046mL); IS3 with the same NA syringe at 2mL/h directly connected to the central venous catheter. Mean arterial pressure (MAP) was obtained from retrospective data analysis of ICU patients with postoperative septic shock criteria. Infusion systems were compared according to the time required to reach an MAP greater than 65mmHg after the onset of infusion.

Results: Data from 37 patients was analysed. The MAP objective was attained in 14:00 minutes (9:20 - 26:10, n=15) with IS1, in 19:10 minutes (12:20 - 27:20, n=13) with IS2 and in 34:10 minutes (23:10 - 62:30, n=9) with IS3 (P=0.00032).

Conclusion: The use of a double syringe pump system associated with a very low dead-space volume infusion set appears to be the most appropriate system for NA infusion.

Keywords: Administration de médicaments; Analyse de matériel; Drug delivery systems/Instrumentation; Infusions parenteral; Material testing; Noradrenaline/Administration, dosage; Noradrénaline/administration, dosage; Perfusion parentérale.

MeSH terms

  • Adult
  • Aged
  • Arterial Pressure / drug effects*
  • Critical Care
  • Female
  • Hemodynamics / drug effects
  • Humans
  • Infusion Pumps
  • Infusions, Intravenous / instrumentation
  • Infusions, Intravenous / methods
  • Male
  • Middle Aged
  • Norepinephrine / administration & dosage*
  • Norepinephrine / pharmacology*
  • Retrospective Studies
  • Vasoconstrictor Agents / administration & dosage*
  • Vasoconstrictor Agents / pharmacology*

Substances

  • Vasoconstrictor Agents
  • Norepinephrine