Implementation of a norepinephrine-based protocol for management of septic shock: a pilot feasibility study

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dc.contributor.authorHernández P., Glenn
dc.contributor.authorBruhn, Alejandro
dc.contributor.authorRomero Patiño, Carlos
dc.contributor.authorLarrondo Gálvez, Francisco Andrés
dc.contributor.authorDe la Fuente Sanhueza, René
dc.contributor.authorCornejo, Rodrigo
dc.contributor.authorCastillo Fuenzalida, Luis Benito
dc.contributor.authorBugedo Tarraza, Guillermo
dc.date.accessioned2023-06-30T20:35:13Z
dc.date.available2023-06-30T20:35:13Z
dc.date.issued2006
dc.description.abstractBackground: The subject of the best vasopressor for hemodynamic management of septic shock (SS) is controversial. One of the difficulties in planning such studies is that physicians are reluctant to use one vasopressor exclusively, and there is considerable variation in practice. The aim of this study was to test the feasibility of implementing a single pressor-based algorithm (in this case, norepinephrine [NE]). Methods: A NE-based algorithm was applied prospectively to 100 consecutive SS patients. A formal training program was implemented before starting the protocol and applied to 72 physicians and nurses involved in intensive care unit (ICU) patient care. Compliance, protocol violations, probable adverse effects, and outcome were evaluated on a daily basis by an independent group of fellows and a research nurse. Results: In 100 patients, there were 7,139 hours of algorithm use. Only 13 protocol violations were observed, mostly in the timing of inotropic drugs. Senior staff physicians or busy night shifts accounted for most of these violations. ICU mortality was 33%, which is comparable to that predicted by Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. Adverse events probably related to NE were not observed. Conclusions: The present algorithm, applied after a strict training program, obtained an overall good acceptance and compliance with very few protocol violations in more than 7,000 hours of use. Safety was demonstrated by a global mortality comparable to that predicted by severity scores and absence of specific drugrelated morbidity. The implementation of a single pressor-based algorithm for SS is feasible and safe.
dc.fechaingreso.objetodigital2023-06-13
dc.format.extent5 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1097/01.ta.0000202062.49814.f4
dc.identifier.issn2163-0755
dc.identifier.urihttp://doi.org/10.1097/01.ta.0000202062.49814.f4
dc.identifier.urihttps://pubmed.ncbi.nlm.nih.gov/16456439/
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/74019
dc.information.autorucEscuela de Medicina ; Hernández P., Glenn ; S/I ; 98874
dc.information.autorucEscuela de Medicina ; Bruhn, Alejandro ; 0000-0001-8034-1937 ; 741
dc.information.autorucEscuela de Medicina ; Romero Patiño, Carlos ; S/I ; 123393
dc.information.autorucEscuela de Medicina ; Larrondo Gálvez, Francisco Andrés ; S/I ; 6810
dc.information.autorucEscuela de Medicina ; De la Fuente Sanhueza, René ; 0000-0001-7187-3405 ; 102089
dc.information.autorucEscuela de Medicina ; Cornejo, Rodrigo ; 0000-0002-0497-5740 ; 146070
dc.information.autorucEscuela de Medicina ; Castillo Fuenzalida, Luis Benito ; S/I ; 54397
dc.information.autorucEscuela de Medicina ; Bugedo Tarraza, Guillermo ; 0000-0001-7527-6202 ; 60490
dc.issue.numero1
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final81
dc.pagina.inicio77
dc.revistaThe Journal of Trauma and Acute Care Surgery
dc.rightsacceso restringido
dc.subjectClinical algorithm
dc.subjectNorepinephrine
dc.subjectSeptic shock
dc.titleImplementation of a norepinephrine-based protocol for management of septic shock: a pilot feasibility study
dc.typeartículo
dc.volumen60
sipa.codpersvinculados98874
sipa.codpersvinculados741
sipa.codpersvinculados123393
sipa.codpersvinculados6810
sipa.codpersvinculados102089
sipa.codpersvinculados146070
sipa.codpersvinculados54397
sipa.codpersvinculados60490
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