Powered by OpenAIRE graph
Found an issue? Give us feedback
addClaim

This Research product is the result of merged Research products in OpenAIRE.

You have already added 0 works in your ORCID record related to the merged Research product.

Vasopressors and Inotropes

Authors: Scott W. Mueller; Robert MacLaren;

Vasopressors and Inotropes

Abstract

Medication errors and adverse drug events occur more frequently in the intensive care unit compared to general care units.1 Adverse drug events become more likely as patients receive more medications. Sentinel events and medication errors are more common as the number of failing organs increases.2,3 Vasopressors are frequently associated with adverse drug events and they are considered high-alert drugs by the Institute of Safe Medication Practices due to their increased potential to cause harm.4-6 Vasopressors and inotropes are used in patients with the highest acuity and under stressful situations which adds to the potential for errors. In addition, dosing guidelines, ranges and units are not always standardized across agents at specific institutions or for a certain agent across institutions. The literature is disparate with respect to dosing recommendations. With the exception of vasopressin, we report the dosing of these agents in a weight-based manner. This should enhance dosing consistency to help minimize errors. We encourage institutions to adopt this dosing scheme to reduce discrepancies associated with their administration. Moreover, using a weight based dosing strategy in an era of increasing obesity raises the question of whether actual, adjusted or ideal body weight should be used when administering vasopressors. No data are available to select an appropriate weight and trials evaluating the use of vasopressors rarely report the body weight used in cases of obesity. With the exception of milrinone, we encourage the use of ideal body weight for all weight-based dosing strategies because these agents possess short half-lives, rapid onsets, and low volumes of distribution but may be associated with severe adverse events when higher weights are used resulting in higher doses in heavier patients. Moreover, these agents are rapidly titrated to clinical response, so starting at lower doses based on ideal body weight is prudent.

Related Organizations
  • BIP!
    Impact byBIP!
    citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    1
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Average
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
Powered by OpenAIRE graph
Found an issue? Give us feedback
citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
Upload OA version
Are you the author of this publication? Upload your Open Access version to Zenodo!
It’s fast and easy, just two clicks!