Extensive variability in vasoactive agent therapy: a nationwide survey in Chinese intensive care units.
- Author:
Xian-Bo PEI
;
Peng-Lin MA
;
Jian-Guo LI
1
;
Zhao-Hui DU
;
Qing ZHOU
;
Zhang-Hong LU
;
Luo YUN
;
Bo HU
Author Information
- Publication Type:Journal Article
- MeSH: Data Collection; Dobutamine; therapeutic use; Dopamine; therapeutic use; Humans; Intensive Care Units; statistics & numerical data; Norepinephrine; therapeutic use; Shock; drug therapy; Shock, Cardiogenic; drug therapy; Shock, Septic; drug therapy; Surveys and Questionnaires; Vasoconstrictor Agents; therapeutic use; Vasodilator Agents; therapeutic use
- From: Chinese Medical Journal 2015;128(8):1014-1020
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDInconsistencies in the use of the vasoactive agent therapy to treat shock are found in previous studies. A descriptive study was proposed to investigate current use of vasoactive agents for patients with shock in Chinese intensive care settings.
METHODSA nationwide survey of physicians was conducted from August 17 to December 30, 2012. Physicians were asked to complete a questionnaire which focused on the selection of vasoactive agents, management in the use of vasopressor/inotropic therapy, monitoring protocols when using these agents, and demographic characteristics.
RESULTSThe response rate was 65.1% with physicians returning 586 valid questionnaires. Norepinephrine was the first choice of a vasopressor used to treat septic shock by 70.8% of respondents; 73.4% of respondents favored dopamine for hypovolemic shock; and 68.3% of respondents preferred dopamine for cardiogenic shock. Dobutamine was selected by 84.1%, 64.5%, and 60.6% of respondents for septic, hypovolemic, and cardiogenic shock, respectively. Vasodilator agents were prescribed by physicians in the management of cardiogenic shock (67.1%) rather than for septic (32.3%) and hypovolemic shock (6.5%). A significant number of physicians working in teaching hospitals were using vasoactive agents in an appropriate manner when compared to physicians in nonteaching hospitals.
CONCLUSIONSVasoactive agent use for treatment of shock is inconsistent according to self-report by Chinese intensive care physicians; however, the variation in use depends upon the form of shock being treated and the type of hospital; thus, corresponding educational programs about vasoactive agent use for shock management should be considered.