OBJECTIVE: The objective of the study was to perform a descriptive approach of the current use of catecholamines by French physicians. DESIGN: A questionnaire of 12 questions with 4 items established by a group of French intensivists. POPULATION: French physicians from 433 departments working in the following practicing areas: intensive care unit (ICU), emergency department, and pre-hospital setting. MEASUREMENTS: Responding physicians were asked about the catecholamine that they would select in various clinical settings. RESULTS: The response rate was 82%. Of the responding physicians, 277 (78%) worked in an ICU, 28 (8%) in an emergency department, and 21 (6%) in a pre-hospital setting. Dobutamine was chosen for patients with cardiogenic shock by 90% of the respondents. Norepinephrine was the first choice agent as vasopressor in patients with septic shock in 52% of the cases. Dopamine was selected in a clinical setting requiring an optimization of regional blood flow, as in the concept of high-risk surgical patients. Dopexamine was used as a second or third choice agent to improve regional blood flow and cardiac output. The indications of epinephrine for anaphylactic shock and cardio-circulatory arrest were obvious for more than 90% of responding physicians. CONCLUSION: A lack of standardization appears in the use of catecholamines by French physicians, particularly for improvement of regional circulation and management of high-risk surgical patients. Guidelines that define the place of each catecholamine in these settings are required to improve the quality of prescription.
OBJECTIVE: The objective of the study was to perform a descriptive approach of the current use of catecholamines by French physicians. DESIGN: A questionnaire of 12 questions with 4 items established by a group of French intensivists. POPULATION: French physicians from 433 departments working in the following practicing areas: intensive care unit (ICU), emergency department, and pre-hospital setting. MEASUREMENTS: Responding physicians were asked about the catecholamine that they would select in various clinical settings. RESULTS: The response rate was 82%. Of the responding physicians, 277 (78%) worked in an ICU, 28 (8%) in an emergency department, and 21 (6%) in a pre-hospital setting. Dobutamine was chosen for patients with cardiogenic shock by 90% of the respondents. Norepinephrine was the first choice agent as vasopressor in patients with septic shock in 52% of the cases. Dopamine was selected in a clinical setting requiring an optimization of regional blood flow, as in the concept of high-risk surgical patients. Dopexamine was used as a second or third choice agent to improve regional blood flow and cardiac output. The indications of epinephrine for anaphylactic shock and cardio-circulatory arrest were obvious for more than 90% of responding physicians. CONCLUSION: A lack of standardization appears in the use of catecholamines by French physicians, particularly for improvement of regional circulation and management of high-risk surgical patients. Guidelines that define the place of each catecholamine in these settings are required to improve the quality of prescription.
Authors: Julia Schumann; Eva C Henrich; Hellen Strobl; Roland Prondzinsky; Sophie Weiche; Holger Thiele; Karl Werdan; Stefan Frantz; Susanne Unverzagt Journal: Cochrane Database Syst Rev Date: 2018-01-29
Authors: Sophie Rym Hamada; Tobias Gauss; Jakob Pann; Martin Dünser; Marc Leone; Jacques Duranteau Journal: Crit Care Date: 2015-12-08 Impact factor: 9.097