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Shock treatment in a cohort of Scandinavian intensive care units in 2014

Kollind, M ; Wickbom, F LU orcid ; Wilkman, E ; Snäckestrand, M S C ; Holmén, A ; Oldner, A ; Perner, A ; Åneman, A and Chew, M S LU (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.

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author
; ; ; ; ; ; ; and
author collaboration
publishing date
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}},
}