Extensive variability in vasoactive agent therapy: a nationwide survey in Chinese intensive care units

Chin Med J (Engl). 2015 Apr 20;128(8):1014-20. doi: 10.4103/0366-6999.155064.

Abstract

Background: Inconsistencies 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.

Methods: A 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.

Results: The 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.

Conclusions: Vasoactive 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.

MeSH terms

  • 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

Substances

  • Vasoconstrictor Agents
  • Vasodilator Agents
  • Dobutamine
  • Dopamine
  • Norepinephrine