Trends of vasopressor use in intensive care units in Colombia

• Published in: Colombian journal of anesthesiology (Inglâes) Vol. 49; no. 4
• Main Authors: Gaviria-Mendoza, Andrés, Machado-Alba, Jorge Enrique, Benítez-Mejía, Juan Felipe, Correa-Ruiz, Santiago, Restrepo-López, Juan Sebastián, Moreno-Gutiérrez, Paula Andrea, Gómez-González, José Fernando
• Format: Journal Article
• Language: English; Portuguese
• Published: SCARE-Sociedad Colombiana de Anestesiología y Reanimación 01.12.2021
• Subjects: ANESTHESIOLOGY; Shock; Pharmacoepidemiology; Intensive Care Units; Vasopresores; Farmacoepidemiología; Choque; Norepinefrina; Vasopressors; Norepinephrine; Prescripciones de medicamentos; Unidades de cuidados intensivos; Drug prescription
• ISSN: 2422-0248; 2256-2087; 2256-2087
• DOI: 10.5554/22562087.e996

Introduction: Vasopressors are essential in the management of various types of shock. Objective: To establish the trend of vasopressors use in the intensive care units (ICU) in a population of patients affiliated with the Colombian Health System, 2010-2017. Methods: Observational trial using a population database of patients hospitalized in eleven ICUs in various cities in Colombia. The drugs dispensed to hospitalized patients over 18 years old, from January 2010 until December 2017 were considered. A review and analysis of the vasopressors dispensed per month was conducted, taking into account sociodemographic and pharmacological variables (vasopressor used and daily doses defined per 100/beds/day (DBD). Results: 81,348 dispensations of vasopressors, equivalent to 26,414 treatments in 19,186 patients receiving care in 11 hospitals from 7 cities were reviewed. The mean age of patients was 66.3±18.1 years and 52.6 % were males. Of the total number of treatments recorded, 17,658 (66.8 %) were with just one vasopressor. Norepinephrine was the most frequently prescribed drug (75.9 % of the prescriptions dispensed; 60.5 DBD), followed by adrenaline (26.6 %; 41.6 DBD), dopamine (19.4%), dobutamine (16.0 %), vasopressin (8.5 %) and phenylephrine (0.9 %). The use of norepinephrine increased from 2010 to 2017 (+6.19 DBD), whilst the use of other drugs decreased, particularly the use of adrenaline (-60.6 DBD) and dopamine (-10.8 DBD). Conclusions: Norepinephrine is the most widely used vasopressor showing a growing trend in terms of its use during the study period, which is supported by evidence in favor of its effectiveness and safety in patients with shock.