alexa Impact of Norepinephrine Shortage on Outcomes in Patients with Septic Shock

Research & Reviews: Journal of Hospital and Clinical Pharmacy
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Research Article

Impact of Norepinephrine Shortage on Outcomes in Patients with Septic Shock

Jean M Nappi1,2*, Adam Sieg3, Tanna B Hassig1,2, Amy E Wahlquist4

1College of Pharmacy, Medical University of South Carolina, Charleston, South Carolina, USA

2Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA

3Department of Pharmacy Services, Memorial Hermann-Texas Medical Center, Houston, Texas, USA

4Department of Public Health, Medical University of South Carolina, Charleston, South Carolina, USA

*Corresponding Author:
Jean Nappi
Pharm. D., Medical University of South Carolina
Charleston, South Carolina, USA
Tel: 8437927628
E-mail: [email protected]

Received 27/04/2016; Accepted 04/05/2016; Published 12/05/2016

 

Abstract

Purpose: With the previous norepinephrine shortage, alternative agents were required to treat patients with septic shock. This retrospective study evaluated whether the shortage of norepinephrine had an adverse effect on patients admitted to the intensive care unit with a diagnosis of severe sepsis or septic shock. Methods: This was a retrospective chart review, which compared patients who received norepinephrine versus those who did not. Eligible patients were those ≥ years old who were admitted to an intensive care unit with a diagnosis of sepsis and were initiated on a vasopressor to maintain hemodynamic stability. The specific primary endpoint was whether using norepinephrine versus other vasopressors had an effect on ICU length of stay. Secondary outcomes included mortality, blood pressure, mean arterial pressure, development of renal insufficiency, and vasopressor requirements. Results: There were 288 patients screened and 214 patients who met the inclusion criteria (norepinephrine group=106 and nonnorepinephrine group=108). After accounting for potential differences in disease severity (APACHE II score), age, weight and gender, there was no difference in ICU length of stay (p=0.4); however, the odds of survival were 5.9 (95% CI: 3.1 to 11.1) times higher for those in the non-norepinephrine group (p<0.0001). Conclusion: Based on this retrospective analysis, patients that did not receive norepinephrine had a similar ICU LOS but had a higher rate of survival. The norepinephrine shortage did not have an adverse effect on patient outcomes. sets for IV-SC conversion may get better clinical and safety outcomes.

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