Shock treatment in a cohort of Scandinavian intensive care units in 2014
(2016) In Acta Anaesthesiologica Scandinavica 60(7). p.945-957- Abstract
BACKGROUND: Shock is common in intensive care units, and treatment includes fluids, vasopressor and/or inotropic drugs, guided by hemodynamic monitoring. The aim of this study was to identify current practice for treatment of shock in Scandinavian intensive care units.
METHODS: Seven-day inception cohort study in 43 intensive care units in Scandinavia. Patients ≥ 15 years old receiving more than 4 h of cardiovascular acting drug infusion were included. The use of fluids, vasopressor and inotropic drugs, type of monitoring, and target values were recorded.
RESULTS: One hundred and seventy-one patients were included. At inclusion, 136/168 (81%) had received vasopressor and/or inotropic drug therapy for less than 24 h, and... (More)
BACKGROUND: Shock is common in intensive care units, and treatment includes fluids, vasopressor and/or inotropic drugs, guided by hemodynamic monitoring. The aim of this study was to identify current practice for treatment of shock in Scandinavian intensive care units.
METHODS: Seven-day inception cohort study in 43 intensive care units in Scandinavia. Patients ≥ 15 years old receiving more than 4 h of cardiovascular acting drug infusion were included. The use of fluids, vasopressor and inotropic drugs, type of monitoring, and target values were recorded.
RESULTS: One hundred and seventy-one patients were included. At inclusion, 136/168 (81%) had received vasopressor and/or inotropic drug therapy for less than 24 h, and 143/171 (84%) had received volume loading before the onset of vasoactive drug treatment. Ringer's solution was given to 129/143 (90%) of patients and starches in 3/143 (2%) patients. Noradrenaline was the most commonly used cardiovascular acting drug, given in 168/171 (98%) of cases while dopamine was rarely used. Mean arterial pressure was considered the most important variable for hemodynamic monitoring. Invasive arterial blood pressure was monitored in 166/171 (97%) of patients, arterial pulse wave analysis in 11/171 (7%), and echocardiography in 50/171 (29%).
CONCLUSION: In this survey, Ringer's solution and noradrenaline were the most common first-line treatments in shock. The use of starches and dopamine were rare. Almost all patients were monitored with invasive arterial blood pressure, but comprehensive hemodynamic monitoring was used only in a minority of patients.
(Less)
- author
- Kollind, M
; Wickbom, F
LU
; Wilkman, E ; Snäckestrand, M S C ; Holmén, A ; Oldner, A ; Perner, A ; Åneman, A and Chew, M S LU
- author collaboration
- publishing date
- 2016
- type
- Contribution to journal
- publication status
- published
- keywords
- Cohort Studies, Humans, Intensive Care Units, Monitoring, Physiologic, Shock, Vasoconstrictor Agents
- in
- Acta Anaesthesiologica Scandinavica
- volume
- 60
- issue
- 7
- pages
- 945 - 957
- publisher
- Blackwell Munksgaard
- external identifiers
-
- pmid:27291070
- scopus:84978647162
- ISSN
- 0001-5172
- DOI
- 10.1111/aas.12745
- language
- English
- LU publication?
- no
- additional info
- © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
- id
- 91d48888-68ef-4f8a-8613-043100568edd
- date added to LUP
- 2025-04-22 08:23:49
- date last changed
- 2025-04-23 04:01:04
@article{91d48888-68ef-4f8a-8613-043100568edd, abstract = {{<p>BACKGROUND: Shock is common in intensive care units, and treatment includes fluids, vasopressor and/or inotropic drugs, guided by hemodynamic monitoring. The aim of this study was to identify current practice for treatment of shock in Scandinavian intensive care units.</p><p>METHODS: Seven-day inception cohort study in 43 intensive care units in Scandinavia. Patients ≥ 15 years old receiving more than 4 h of cardiovascular acting drug infusion were included. The use of fluids, vasopressor and inotropic drugs, type of monitoring, and target values were recorded.</p><p>RESULTS: One hundred and seventy-one patients were included. At inclusion, 136/168 (81%) had received vasopressor and/or inotropic drug therapy for less than 24 h, and 143/171 (84%) had received volume loading before the onset of vasoactive drug treatment. Ringer's solution was given to 129/143 (90%) of patients and starches in 3/143 (2%) patients. Noradrenaline was the most commonly used cardiovascular acting drug, given in 168/171 (98%) of cases while dopamine was rarely used. Mean arterial pressure was considered the most important variable for hemodynamic monitoring. Invasive arterial blood pressure was monitored in 166/171 (97%) of patients, arterial pulse wave analysis in 11/171 (7%), and echocardiography in 50/171 (29%).</p><p>CONCLUSION: In this survey, Ringer's solution and noradrenaline were the most common first-line treatments in shock. The use of starches and dopamine were rare. Almost all patients were monitored with invasive arterial blood pressure, but comprehensive hemodynamic monitoring was used only in a minority of patients.</p>}}, author = {{Kollind, M and Wickbom, F and Wilkman, E and Snäckestrand, M S C and Holmén, A and Oldner, A and Perner, A and Åneman, A and Chew, M S}}, issn = {{0001-5172}}, keywords = {{Cohort Studies; Humans; Intensive Care Units; Monitoring, Physiologic; Shock; Vasoconstrictor Agents}}, language = {{eng}}, number = {{7}}, pages = {{945--957}}, publisher = {{Blackwell Munksgaard}}, series = {{Acta Anaesthesiologica Scandinavica}}, title = {{Shock treatment in a cohort of Scandinavian intensive care units in 2014}}, url = {{http://dx.doi.org/10.1111/aas.12745}}, doi = {{10.1111/aas.12745}}, volume = {{60}}, year = {{2016}}, }