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Scandinavian SSAI clinical practice guideline on choice of first-line vasopressor for patients with acute circulatory failure
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
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2016 (English)In: Acta Anaesthesiol ScandArticle in journal (Refereed) Published
Abstract [en]

BACKGROUND: Adult critically ill patients often suffer from acute circulatory failure, necessitating use of vasopressor therapy. The aim of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force for Acute Circulatory Failure was to present clinically relevant, evidence-based treatment recommendations on this topic. METHODS: This guideline was developed according to standards for trustworthy guidelines, including a systematic review of the literature and use of the GRADE methodology for assessment of the quality of evidence and for moving from evidence to recommendations. We assessed the following subpopulations of patients with acute circulatory failure: 1) shock in general, 2) septic shock, 3) cardiogenic shock, 4) hypovolemic shock and 5) other types of shock, including vasodilatory shock. We assessed patient-important outcome measures, including mortality, serious adverse reactions and quality-of-life. RESULTS: For patients with shock in general and those with septic shock, we recommend using norepinephrine rather than dopamine, and we suggest using norepinephrine rather than epinephrine, vasopressin analogues, and phenylephrine. For patients with cardiogenic shock and those with hypovolemic shock, we suggest using norepinephrine rather than dopamine, and we provide no recommendations/suggestions of norepinephrine vs. epinephrine, vasopressin analogues, and phenylephrine. For patients with other types of shock, including vasodilatory shock, we suggest using norepinephrine rather than dopamine, epinephrine, vasopressin analogues, and phenylephrine. CONCLUSIONS: We recommend using norepinephrine rather than other vasopressors as first-line treatment for the majority of adult critically ill patients with acute circulatory failure.

Place, publisher, year, edition, pages
2016.
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:umu:diva-125091ISBN: 1399-6576 (Electronic) 0001-5172 (Linking)OAI: oai:DiVA.org:umu-125091DiVA: diva2:957930
Note

Moller, M H Claudius, C Junttila, E Haney, M Oscarsson-Tibblin, A Haavind, A Perner, A ENG REVIEW 2016/09/01 06:00 Acta Anaesthesiol Scand. 2016 Aug 31. doi: 10.1111/aas.12780.

Available from: 2016-09-05 Created: 2016-09-05 Last updated: 2016-09-05

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http://www.ncbi.nlm.nih.gov/pubmed/27576362http://onlinelibrary.wiley.com/store/10.1111/aas.12780/asset/aas12780.pdf?v=1&t=isq07qyd&s=38d13684a9709d83ac18e5c8aac3bd6a99379a3b

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Haney, M.
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