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Minerva anestesiologica · Jun 2021
Good clinical practice for the use of vasopressor and inotropic drugs in critically ill patients: state-of-the-science and expert consensus.
- Andrea Carsetti, Elena Bignami, Andrea Cortegiani, Katia Donadello, Abele Donati, Giuseppe Foti, Giacomo Grasselli, Stefano Romagnoli, Massimo Antonelli, Elvio DE Blasio, Francesco Forfori, Fabio Guarracino, Sabino Scolletta, Luigi Tritapepe, Luigia Scudeller, Maurizio Cecconi, and Massimo Girardis.
- Anesthesia and Intensive Care Unit, Ospedali Riuniti University Hospital, Ancona, Italy - a.carsetti@univpm.it.
- Minerva Anestesiol. 2021 Jun 1; 87 (6): 714-732.
AbstractVasopressors and inotropic agents are widely used in critical care. However, strong evidence supporting their use in critically ill patients is lacking in many clinical scenarios. Thus, the Italian Society of Anesthesia and Intensive Care (SIAARTI) promoted a project aimed to provide indications for good clinical practice on the use of vasopressors and inotropes, and on the management of critically ill patients with shock. A panel of 16 experts in the field of intensive care medicine and hemodynamics has been established. Systematic review of the available literature was performed based on PICO questions. Basing on available evidence, the panel prepared a summary of evidence and then wrote the clinical questions. A modified semi-quantitative RAND/UCLA appropriateness method has been used to determine the appropriateness of specific clinical scenarios. The panel identified 29 clinical questions for the use of vasopressors and inotropes in patients with septic shock and cardiogenic shock. High level of agreement exists among the panel members about appropriateness of inotropes/vasopressors' use in patients with septic shock and cardiogenic shock.
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