Clinical Outcomes of Weight-Based Norepinephrine Dosing in Underweight and Morbidly Obese Patients: A Propensity-Matched Analysis.
Aged
Body Mass Index
Critical Care Outcomes
Drug Dosage Calculations
Female
Hospital Mortality
Humans
Intensive Care Units
Male
Middle Aged
Norepinephrine
/ administration & dosage
Obesity, Morbid
/ complications
Odds Ratio
Propensity Score
Retrospective Studies
Shock, Septic
/ drug therapy
Thinness
/ complications
mortality
norepinephrine
obesity
septic shock
underweight
Journal
Journal of intensive care medicine
ISSN: 1525-1489
Titre abrégé: J Intensive Care Med
Pays: United States
ID NLM: 8610344
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
pubmed:
10
4
2018
medline:
20
2
2021
entrez:
10
4
2018
Statut:
ppublish
Résumé
Weight-based dosing strategy for norepinephrine in septic shock patients with extremes of body mass index has been lesser studied. This historical study of adult septic shock patients was conducted from January 1, 2010, to December 31, 2015, at all intensive care units (ICUs) in Mayo Clinic, Rochester. Patients with documented body mass index were classified into underweight (body mass index <18.5 kg/m From 2010 to 2015, 2016 patients met inclusion-145, 1406, and 466 patients, respectively, in underweight, normal weight, and morbidly obese cohorts. Underweight patients used the highest peak dose and absolute exposure was greatest for morbidly obese patients. In-hospital mortality decreased with increasing log Morbidly obese patients had lower in-hospital mortality but had higher 1-year mortality compared to normal weight and underweight patients. Cumulative norepinephrine exposure was highest in morbidly obese patients. Total norepinephrine exposure was an independent mortality predictor in septic shock.
Sections du résumé
BACKGROUND
BACKGROUND
Weight-based dosing strategy for norepinephrine in septic shock patients with extremes of body mass index has been lesser studied.
METHODS
METHODS
This historical study of adult septic shock patients was conducted from January 1, 2010, to December 31, 2015, at all intensive care units (ICUs) in Mayo Clinic, Rochester. Patients with documented body mass index were classified into underweight (body mass index <18.5 kg/m
RESULTS
RESULTS
From 2010 to 2015, 2016 patients met inclusion-145, 1406, and 466 patients, respectively, in underweight, normal weight, and morbidly obese cohorts. Underweight patients used the highest peak dose and absolute exposure was greatest for morbidly obese patients. In-hospital mortality decreased with increasing log
CONCLUSIONS
CONCLUSIONS
Morbidly obese patients had lower in-hospital mortality but had higher 1-year mortality compared to normal weight and underweight patients. Cumulative norepinephrine exposure was highest in morbidly obese patients. Total norepinephrine exposure was an independent mortality predictor in septic shock.
Identifiants
pubmed: 29628015
doi: 10.1177/0885066618768180
doi:
Substances chimiques
Norepinephrine
X4W3ENH1CV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM